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Review
. 2022 Mar;100(2):e327-e338.
doi: 10.1111/aos.14906. Epub 2021 May 14.

Microinvasive glaucoma surgery: a review and classification of implant-dependent procedures and techniques

Joanna Jabłońska  1 , Katarzyna Lewczuk  1 , Joanna Konopińska  2 , Zofia Mariak  2 , Marek Rękas  1
Affiliations
Review

Microinvasive glaucoma surgery: a review and classification of implant-dependent procedures and techniques

Joanna Jabłońska et al. Acta Ophthalmol. 2022 Mar.

Abstract

The aim of this article is to discuss how physiology and anatomical background affect the effectiveness of implant-dependent microinvasive glaucoma surgery (MIGS). First, we provide a micro view of aqueous outflow and tissue behaviour. Second, we review studies exploring the mechanisms of the pressure-lowering effect of MIGS, as well as tissue behaviour during aqueous flow and tissue motion. We also describe and classify microinvasive surgical procedures and the most important types of implants, as well as their mechanisms of action, implantation techniques and efficacy. Further, we summarize the indications and surgical results presented in recent studies, providing an evidence-based update on novel and emerging MIGS techniques for the treatment of open-angle glaucoma. These data can help surgeons to personalize the management of glaucoma and to choose the best MIGS option for individual glaucoma patients.

Keywords: MIGS; glaucoma; implants; microinvasive surgery.

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Figures

Fig. 1
Fig. 1
Aqueous vein density.
Fig. 2
Fig. 2
Cyclodialysis is visible in ultrasound biomicroscopy.
Fig. 3
Fig. 3
iStent® Inject implant.
Fig. 4
Fig. 4
iStent® Supra implant.
Fig. 5
Fig. 5
iStent® implant inserted during gonioscopy.
Fig. 6
Fig. 6
A Hydrus® implant.
Fig. 7
Fig. 7
A Hydrus® implant in gonioscopy.
Fig. 8
Fig. 8
A XEN® implant.
Fig. 9
Fig. 9
A CyPass® implant in a gonioscopy
Fig. 10
Fig. 10
A CyPass® implant observed using an OCT Visante.
Fig. 11
Fig. 11
A CyPass® implant.
See this image and copyright information in PMC

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