Newer Devices for Aqueous Drainage

  • Reena Choudhry
  • Isha Vatsal
  • Foram Desai


Glaucoma is the leading cause of irreversible blindness worldwide [1, 2]. Though trabeculectomy still remains the “gold standard” in glaucoma surgery, it is associated with significant morbidity such as hypotony and bleb-related complications [3–5]. With this background, there has been a constant search for alternative procedures that are less invasive and safer, have optimal IOP-lowering effect, and improve quality of life in patients with chronic glaucoma.


  1. 1.
    Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–90.CrossRefGoogle Scholar
  2. 2.
    Richter GM, Coleman AL. Minimally invasive glaucoma surgery: current status and future prospects. Clin Ophthalmol. 2016;10:189–206.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Jeffrey R, SooHoo MD, Leonard K, Seibold M, Nathan M, Radcliffe M, Malik Y, Kahook MD. Minimally invasive glaucoma surgery: current implants and future innovations. Can J Ophthalmol. 2014;49(6):528–33.CrossRefGoogle Scholar
  4. 4.
    Brandão LM, Grieshaber MC. Update on minimally invasive glaucoma surgery (MIGS) and new implants. J Ophthalmol. 2013;2013:705915, 12 pages.CrossRefGoogle Scholar
  5. 5.
    Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC, Tube Versus Trabeculectomy Study Group. Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up. Am J Ophthalmol. 2012;153:804–14.CrossRefGoogle Scholar
  6. 6.
    Johnson M. What controls aqueous humour outflow resistance? Exp Eye Res. 2006;82:545–57.CrossRefGoogle Scholar
  7. 7.
    Minckler DS, Baerveldt G, Alfaro MR, Francis BA. Clinical results with the Trabectome for treatment of open-angle glaucoma. Ophthalmology. 2005;112:962–7.CrossRefGoogle Scholar
  8. 8.
    Minickler D, Mosaed S, Dustin L, Trabectome Study Group. Trabectome (trabeculectomy-internal approach): additional experience and extended follow up. Trans Am Ophthalmol Soc. 2008;106:149–60.Google Scholar
  9. 9.
    Francis BA, See RF, Rao NA, Minckler DS, Baerveldt G. Ab interno trabeculectomy: development of a novel device(Trabectome) and surgery for open angle glaucoma. J Glaucoma. 2006;15:68–73.CrossRefGoogle Scholar
  10. 10.
    Ahuja Y, Ma Khin Pyi S, Malihi M, Hodge DO, Sit AJ. Clinical results of ab interno trabeculotomy using the trabectome for open-angle glaucoma: the Mayo clinic series in Rochester, Minnesota. Am J Ophthalmol. 2013;156:927–35.CrossRefGoogle Scholar
  11. 11.
    Ahuja Y, Malihi M, Sit AJ. Delayed-onset symptomatic hyphema after ab interno trabeculotomy surgery. Am J Ophthalmol. 2012;154:476–80.CrossRefGoogle Scholar
  12. 12.
    Minckler D, Mosaed S, Dustin L, et al. Trabectome (trabeculectomy-internal approach): additional experience and extended follow-up. Trans Am Ophthalmol Soc. 2008;106:149–59.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Babighian S, Caretti L, Tavolato M, Cian R, Galan A. Excimer laser trabeculotomy vs 180 degrees selective laser trabeculoplasty in primary open-angle glaucoma. A 2-year randomized, controlled trial. Eye (Lond). 2010;24:632–8.CrossRefGoogle Scholar
  14. 14.
    Voskanyan L, García-Feijoó J, Belda JI, Fea A, Jünemann A, Baudouin C. Synergy Study Group Prospective, unmasked evaluation of the iStent® inject system for open-angle glaucoma: synergy trial. Adv Ther. 2014;31:189–201.CrossRefGoogle Scholar
  15. 15.
    Samuelson TW, Katz LF, Wells JM, Duh YJ, Giamporcaro JE, US iStent Study Group. Randomized evaluation of the trabecular micro-bypass stent with phacoemulsification in patients with glaucoma and cataract. Ophthalmology. 2011;118:459–67.CrossRefGoogle Scholar
  16. 16.
    Johnstone MA, Grant WG. Pressure-dependent changes in structures of the aqueous outflow system of human and monkey eyes. Am J Ophthalmol. 1973;75:365–83.CrossRefGoogle Scholar
  17. 17.
    Pfeiffer N, Garcia-Feijoo J, Martinez-de-la-Casa JM, et al. A randomized trial of a Schlemm’s canal microstent with phacoemulsification for reducing intraocular pressure in open-angle glaucoma. Ophthalmology. 2015;122:1283–93.CrossRefGoogle Scholar
  18. 18.
    Saheb H, Ianchulev T, Ahmed II. Optical coherence tomography of the suprachoroid after CyPass Micro-Stent implantation for the treatment of open-angle glaucoma. Br J Ophthalmol. 2014;98:19–23.CrossRefGoogle Scholar
  19. 19.
    García-Feijoo J, Rau M, Grisanti S, et al. Supraciliary micro-stent implantation for open-angle glaucoma failing topical therapy: 1-year results of a multicenter study. Am J Ophthalmol. 2015;159:1075–81.CrossRefGoogle Scholar
  20. 20.
    Hoeh H, Ahmed IK, Grisanti S, et al. Early postoperative safety and surgical outcomes after implantation of a suprachoroidal micro-stent for the treatment of open-angle glaucoma concomitant with cataract surgery. J Cataract Refract Surg. 2013;39:431–7.CrossRefGoogle Scholar
  21. 21.
    Lewis RA. Ab interno approach to the subconjunctival space using a collagen glaucoma stent. J Cataract Refract Surg. 2014;40:1301–6.CrossRefGoogle Scholar
  22. 22.
    De Gregorio A, Pedrotti E, Russo L, Morselli S. Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent. Int Ophthalmol. 2018;38:1129–34. Scholar
  23. 23.
    Grover DS, Godfrey DG, Smith O, Feuer WJ, Montes de Oca I, Fellman RL. Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results. Ophthalmology. 2014;121:855–61.CrossRefGoogle Scholar
  24. 24.
    Yang HS, Lee J, Choi S. Ocular biometric parameters associated with intraocular pressure reduction after cataract surgery in normal eyes. Am J Ophthalmol. 2013;156:89–94.CrossRefGoogle Scholar
  25. 25.
    Mansberger SL, Gordon MO, Jampel H, et al. Ocular Hypertension Treatment Study Group. Reduction in intraocular pressure after cataract extraction: the Ocular Hypertension Treatment Study. Ophthalmology. 2012;119:1826–1831.CrossRefGoogle Scholar
  26. 26.
    Chen PP, Lin SC, Junk AK, Radhakrishnan S, Singh K, Chen TC. The effect of phacoemulsification on intraocular pressure in glaucoma patients: a report by the American Academy of Ophthalmology. Ophthalmology. 2015;122:1294–307.CrossRefGoogle Scholar
  27. 27.
    Schmidt W, Kastner C, Sternberg K, et al. New concepts for glaucoma implants – controlled aqueous humor drainage, encapsulation prevention and local drug delivery. Curr Pharm Biotechnol. 2013;14:98–111.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Reena Choudhry
    • 1
  • Isha Vatsal
    • 1
  • Foram Desai
    • 1
  1. 1.ICARE Eye Hospital and Post Graduate InstituteNoidaIndia

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