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QUESTION:
I’ve heard that there is a new glaucoma implant available (the InnFocus MicroShunt®) that only requires a small incision in the eye. How does it compare to other minimally-invasive glaucoma surgeries (MIGS)?
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ANSWER:
There seems to be a lot of confusion online regarding some of the newer glaucoma treatment options (in particular the InnFocus MicroShunt® and XEN® Gel Stent). To be clear, placement of the InnFocus MicroShunt® requires an ab-externo incision (through the conjunctiva and sclera, not just the cornea). As such, it is not a MIGS procedure. It’s important to keep in mind that the InnFocus MicroShunt®, XEN® Gel Stent, and EX-PRESS® mini shunt are all essentially variations on the trabeculectomy theme. They all require a functioning bleb and they all share the same risks as trabeculectomy. They were designed to minimize those risks but in no way, shape, or form, have they yet succeeded in eliminating them. Any risk that can be encountered after trabeculectomy may also be experienced after placement of the IInnFocus MicroShunt®, XEN® Gel Stent, or EX-PRESS® mini shunt.
As such, none of these stents/shunts achieve the holy grail of achieving an impressive IOP reduction without high risk. To date ab-externo canaloplasty appears to be the surgical procedure closest to achieving that goal. However, it is both time consuming and technically challenging so very few surgeons have bothered to learn the skills necessary to achieve excellent results. In the meantime (for most patients and surgeons) the choice is less than satisfying: high risk, but highly effective trabs/tubes or low risk but minimally effective MIGS.
Warm regards,
David Richardson, MD
Patient-Focused Ophthalmologist
San Marino Eye
2020 Huntington Drive
San Marino, CA 91108
626.289.7856
Patient-Focused Websites:
New-Glaucoma-Treatments.com
About-Eyes.com
Posted in: Canaloplasty, Canaloplasty and Other Surgeries
