Minimally invasive glaucoma surgery - current and emerging techniques to reduce intraocular pressure and medications

Cataract Surgery Combined with Trabecular MIGS (Minimally Invasive Glaucoma Surgery)

10.5772/intechopen.95416 ◽

2020 ◽

Author(s):

Marina Aguilar González ◽

Jorge Vila Arteaga ◽

Jose Marí Cotino

Keyword(s):

Intraocular Pressure ◽

Minimally Invasive ◽

Cataract Surgery ◽

Excimer Laser ◽

Aqueous Humor ◽

Trabecular Meshwork ◽

Glaucoma Surgery ◽

Minimally Invasive Glaucoma Surgery ◽

Advanced Glaucoma ◽

Physiological Approach

Cataract surgery decreases significantly and with maintained effect intraocular pressure (IOP) in both normal eyes as in eyes with glaucoma. In patients with cataracts and glaucoma, it can be performed, isolated or in combination with other techniques, such as the following: minimally invasive glaucoma surgery (MIGS) in patients with mild/moderate glaucoma that do not require a high tensional decrease; and conventional glaucoma surgery techniques in patients with advanced glaucoma. Although lower than with conventional techniques, MIGS trabecular surgery has a good IOP lowering effect and provides some of the following advantages: a more physiological approach; little traumatic; without bleb; and it does not limit other techniques in the future. Different techniques that combinated or not with cataract surgery facilitate the exit of aqueous humor through the trabecular meshwork (TM) have been described. Our aim in this chapter is to review the newest of them, such as the following: iStent; ELT (Excimer Laser Trabeculostomy); kahook; ABiC; and OMNI.

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Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery: A Prospective Study

Journal of Clinical Medicine ◽

10.3390/jcm10163472 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3472

Author(s):

Bojan Pajic ◽

Mirko Resan ◽

Brigitte Pajic-Eggspuehler ◽

Horace Massa ◽

Zeljka Cvejic

Keyword(s):

Circadian Rhythm ◽

Intraocular Pressure ◽

Minimally Invasive ◽

Prospective Study ◽

Cataract Surgery ◽

High Frequency ◽

Glaucoma Surgery ◽

Before And After ◽

Contact Lens Sensor ◽

A Prospective Study

Background: The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. Methods: In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). Results: After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. Conclusions: HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients.

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