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New system for minimally invasive glaucoma management shows promise
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BASSANO, Italy — A new micro-stent for minimally invasive glaucoma management has shown promising results, according to a surgeon here.
"The future of suprachoroidal implants is mini-invasive surgery with an ab interno approach to spare the conjunctiva and avoid the formation of a filtration bleb," Paolo Martinelli, MD, said at a meeting on mini-invasive surgery.
The CyPass system (Transcend Medical) is a tubular stent made of semi-rigid polymer. It is 0.3 mm in diameter and 6 mm in length, with micro-holes on the surface. It is implanted with a curved delivery device through a clear corneal incision just under the scleral spur. The anterior chamber is filled with viscoelastic, and the surgical maneuvers are carried out with the help of a goniolens. Once the device is implanted, the viscoelastic is removed and the incision is sutured.
"The aqueous filtrates through the lumen and the holes on the surface of the device directly into the suprachoroidal space," Dr. Martinelli said.
The ab interno approach is minimally invasive, and because the conjunctiva is untouched, it does not preclude other surgical options at a later stage. Only a short learning curve is required.
"We implanted four CyPasses in the last month at our University Hospital in Pisa," Dr. Martinelli said. "Our results are too preliminary to draw conclusions, but the 1-year outcomes issued by the company are promising. A 30% to 40% IOP decrease was obtained, with consequent reduction of the medical therapy."
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