Advances in Glaucoma Surgery

Abstract

Currently popular glaucoma filtration surgeries which include trabeculectomy and glaucoma drainage devices have their share of vision-threatening complications. Lately less invasive and safer devices have been developed to be used alone or in conjunction with cataract surgery for lowering the intraocular pressure. These microscopic implants utilize the trabecular pathway, suprachoroidal pathway or subconjunctival route for drainage. The term ‘Micro-Invasive Glaucoma Surgery’ includes surgical procedures that use an ab-interno approach, such as iStent, Trabectome, Hydrus Scaffold shunt, Excimer laser trabeculotomy and CyPass suprachoroidal shunt. Implants which utilize ab-externo approach are canaloplasty with microcatheter, Ex-PRESS glaucoma microshunts, SOLX Gold shunt and Aquashunt. Studies are ongoing to evaluate their efficacy alone or in combination with phacoemulsification and have found encouraging results in early to moderate glaucoma.