EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78710
February 2011May 2012 EW GLAUCOMA 29 other study. Both Drs. Ahmed and Samuelson were part of a study that showed the Hydrus induced a 92% increase in outflow facility. The Trabectome (NeoMedix, Tustin, Calif.) is used for ab interno trabeculectomy to decrease outflow resistance, employs high-frequency electrocautery, and is typically part of a phacotrabeculectomy proce- dure. "An ongoing debate is whether it's better to cauterize or to stent," Dr. Ahmed said. Suprachoroidal devices The CyPass (Transcend Medical, Menlo Park, Calif.) is a MIGS device inserted into the suprachoroidal space during routine cataract sur- gery, immediately after IOL implan- tation. The SOLX Gold Shunt is an ab externo approach that requires more dissection than other devices involving this space, Dr. Samuelson said. "There's no head-to-head com- parisons between the CyPass, the Glaukos suprachoroidal device (G-3), or the SOLX, but it is clear that the SOLX is going to have to work much better than the others to justify the additional dissection necessary for implantation," Dr. Samuelson said. Looking down the road, once the investigational devices are ap- proved for use in the U.S., Dr. Samuelson said trab will still be an important procedure, "but we'll match the appropriate disease risk to the inherent risk of each surgery. There's no need to subject someone with mild-to-moderate glaucoma and minimal field loss to a filtration bleb." Dr. Ahmed agreed, noting pa- tients on one medication with con- trolled IOP don't necessarily need glaucoma surgery, but those who are on two or three medications and/or not well controlled could benefit from the newer MIGS procedures. "Schlemm's canal is arguably the safest place to work, but it's technically the most difficult," he said, "while the suprachoroidal space is the easiest place to work." The key will be perfecting the trade- off between acceptable risk and de- sired outcomes, he said. EW Editors' note: Dr. Ahmed has financial interests with Alcon, AqueSys (Irvine, Calif.), Glaukos, Ivantis, NeoMedix, and Transcend Medical. Dr. Pfeiffer has financial interests with Ivantis. Dr. Samuelson has financial interests with Abbott Medical Optics (Santa Ana, Calif.), Alcon, AqueSys, Glaukos, and Ivantis. Contact information Ahmed: 416-625-3937, ike.ahmed@utoronto.ca Pfeiffer: 49 6131 17 7085, norbert.pfeiffer@unimedizin-mainz.de Samuelson: 612-813-3628, twsamuelson@mneye.com