Eyeworld

Reporting from the 2017 EyeWorld Surgical Summit, February 2–4 2017, Park City, Utah Reporting from the 2017 EyeWorld Surgical Summit, February 2–4 2017, Park City, Utah EW MEETING REPORTER 130 March 2017 Reporting from the 2017 EyeWorld Surgical Summit, February 2–4, 2017, Park City, Utah Reporting from the 2017 EyeWorld Surgical Summit MIGS and more The program began with a session on glaucoma—"The Pressure Is On … To Embrace the New." David Crandall, MD, Detroit, presented the several options avail- able to ophthalmologists working in the canal. Trabectome (NeoMedix, Tustin, California) is a disposable handpiece that ablates a strip of trabecular meshwork and the inner wall of Schlemm's canal up to 120 degrees. Gonioscopy-assisted translumi- nal trabeculotomy (GATT) using the iTrack microcatheter (Ellex, Adelaide, Australia) is passed ab interno 360 degrees through Schlemm's canal and then pulled at both ends out of the canal. Dr. Cran- dall also noted that a GATT proce- dure can be performed with nylon sutures, but it gets difficult to pass the suture beyond 270 degrees, at which point it can be pulled out and worked through the other direction. Complications with GATT included the possibility for further surgery, hyphema, and steroid-included IOP rise. Given the risk for hyphema, Dr. Crandall said he will have patients stop blood-thinning medications prior to surgery, which he does not ask for other glaucoma procedures. Dr. Crandall also mentioned Trab360 (Sight Sciences, Menlo Park, California) and Visco360 (Sight Sci- ences), the latter of which is similar to a GATT procedure but rather than pulling a catheter through the trabecular meshwork, viscoelastic is injected as the 40 mm nylon cathe- ter is removed. Dr. Crandall pointed out that this device only has a total of 40 clicks. Each time the device is advanced forward, it clicks. Once the surgeon has made 40 clicks, it will no longer advance. Finally, the Kahook Dual Blade (New World Medical, Rancho Cu- camonga, California) is designed to pull out of a strip of the trabecular meshwork. Dr. Crandall said you can get about 120 degrees of stripping with this disposable handpiece. Overall, Dr. Crandall said patients with open angle glaucoma can do very well with trabeculotomy procedures, but if a patient cannot stop anticoagulants, has closed angles, or poor corneas, then he ad- vised caution with these options. Richard Lewis, MD, Sacra- mento, California, discussed both suprachoroidal MIGS—the FDA-ap- proved CyPass (Alcon, Fort Worth, Texas) and iStent Supra (Glaukos, San Clemente, California), still in clinical trials—and subconjuncti- Sponsored by

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