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Eyetube Picks | Nov/Dec '16

Staying up to Speed with MIGS

The microinvasive glaucoma surgery (MIGS) space continues to expand, with an increasing number of treatment options moving from bench to bedside. As this occurs, physicians performing or interested in performing MIGS should strive to stay up to speed on the various treatment options and how to best utilize them to achieve optimal outcomes for our glaucoma patients. The four videos featured below can serve as a refresher on some of the technologies available today—stay tuned, though, because it is likely that this list will keep on growing.


With the many treatment options now available for MIGS, surgeons must understand and carefully weigh each approach. In this video, Nathan Radcliffe, MD, discusses his decision tree for selecting the appropriate MIGS procedure for each patient and shares his advice for making informed surgical decisions in these cases.


The CyPass Micro-Stent (Alcon) is currently being commercially launched. I recently performed my first cases and was impressed with the technology and its pressure-lowering efficacy. Check out Dr. Ike Ahmed’s unique side-winder insertion technique approach, which helps outline the steps to consider during CyPass implantation.


The Xen Gel Stent (Allergan), a recently approved device, offers yet another treatment option in the fast-growing MIGS space. In this video, H. Burkhard Dick, MD, PhD, demonstrates an ab interno approach to the subconjunctival space using the Xen Gel Stent in combination with laser cataract surgery.


This unedited video illustrates the use of ab interno canaloplasty, or ABiC, in a phakic patient with primary open-angle glaucoma. During the procedure, goniotomy, 360° cannulation, and viscodilation of Schlemm canal with the iTrack microcatheter (Ellex) are performed.

William F. Wiley, MD
William F. Wiley, MD
  • Medical Director, Cleveland Eye Clinic/Clear Choice LASIK Center in Cleveland, Ohio
  • drwiley@clevelandeyeclinic.com; Twitter @wiley2020
  • Financial interest: None acknowledged