Preclinical Investigation of Ab Interno Trabeculectomy Using a Novel Dual-Blade Device

Seibold, Leonard K.; SooHoo, Jeffrey R.; Ammar, David A.; Kahook, Malik Y.

doi:10.1016/j.ajo.2012.09.023

Cited by 156 publications

(148 citation statements)

References 14 publications

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“…As such, some may argue that they may not qualify as MIGS because there is significant tissue destruction. The Kahook Dual Blade (DKB) (New World Medical, CA, USA) is a novel dual-blade device that elevates and removes the trabecular meshwork, allowing for cleaner removal of the tissue, thus minimizing damage to adjacent structures [44]. There is limited clinical data on the efficacy of this FDA-approved device.…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Microinvasive Glaucoma Surgery

Chen

Sng

2017

Journal of Ophthalmology

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Microinvasive glaucoma surgery (MIGS) is emerging as a new therapeutic option for glaucoma patients who wish to reduce their medication burden and avoid the postoperative complications of conventional glaucoma filtration surgery. These devices differ in terms of their efficacy and safety profile. Schlemm's canal devices have the most favorable safety profile at the compromise of modest efficacy, while subconjunctival and suprachoroidal devices are potentially more effective at lowering the intraocular pressure at the expense of a higher rate of complications. This review consolidates the latest evidence on the efficacy and safety of the MIGS devices in clinical use and provides an overview on upcoming devices which would likely also become viable treatment options in the near future. These clinical data would assist a glaucoma surgeon in selecting the most appropriate MIGS device for each patient based on the glaucoma severity and patient expectations.

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Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Microinvasive Glaucoma Surgery

Chen

Sng

2017

Journal of Ophthalmology

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“…The most common adverse event was hyphema resolving within a week[15]. Preclinical studies using human cadaveric tissue showed the new dual blade device removed trabecular meshwork tissue more completely and without injury to surrounding tissues when compared to the Trabectome®[16]*.…”

Section: 0 Increasing Trabecular Outflowmentioning

confidence: 99%

Microinvasive glaucoma surgery: an evidence-based assessment

Schehlein

Kaleem

Swamy

et al. 2017

Expert Review of Ophthalmology

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Introduction The advent of Microinvasive Glaucoma Surgery (MIGS) offers a novel approach in the treatment of glaucoma with the number of procedures developing at an exciting pace. Areas Covered MIGS procedures aim to lower intraocular pressure (IOP) via four mechanisms: (1) increasing trabecular outflow, (2) increasing outflow via suprachoroidal shunts, (3) reducing aqueous production, and (4) subconjunctival filtration. A comprehensive search for published studies for each Microinvasive Glaucoma Surgery (MIGS) device or procedure was undertaken using the electronic database PubMed. Search terms included ‘minimally invasive glaucoma surgery’, ‘microincisional glaucoma surgery’, and ‘microinvasive glaucoma surgery’. A manual search for each device or procedure was also performed. After review, randomized control trials and prospective studies were preferentially included. Expert Opinion These procedures offer several benefits: an improved safety profile allowing for intervention in earlier stages of glaucoma, combination with cataract surgery, and decreased dependence on patient compliance with topical agents. Established MIGS procedures have proven efficacy and more recent devices and procedures show promising results. Despite this, further study is needed to assess the long term IOP-lowering effectiveness of these procedures. Particularly, rigorous study with more randomized control trials and head-to-head comparisons would allow for better informed clinical and surgical decision-making. MIGS offers new solutions for glaucoma treatment.

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“…While the plasma created at the tip of the electrosurgical trabectome molecularizes the TM and is the more atraumatic and drag-free TM removal technique, it does require a high frequency generator that is not necessary with the goniectome ( http://www.google.com/patents/US6979328) or the dual blade introduced a few years later ( https://patents.google.com/patent/US20150297400A1/en). This device has recently been rekindled for use in operating rooms where a high-frequency generator is not available 7, 8 . Preclinical investigations on ab interno trabeculectomy with the trabectome and a dual-blade device demonstrated a similar decrease in intraocular pressure (IOP) in an eye perfusion model 8 .…”

Section: Introductionmentioning

confidence: 99%

“…This device has recently been rekindled for use in operating rooms where a high-frequency generator is not available 7, 8 . Preclinical investigations on ab interno trabeculectomy with the trabectome and a dual-blade device demonstrated a similar decrease in intraocular pressure (IOP) in an eye perfusion model 8 . A key differentiator among these instruments, however, is the active irrigation and aspiration system that facilitates visualization, a challenge that is well known from the pediatric goniosurgery literature 9– 11 .…”

Section: Introductionmentioning

confidence: 99%

Training strategies and outcomes of ab interno trabeculectomy with the trabectome

Fallano¹,

Bussel²,

Kagemann³

et al. 2017

F1000Res

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Plasma-mediated ab interno trabeculectomy with the trabectome was first approved by the US Food and Drug Administration in 2004 for use in adult and pediatric glaucomas. Since then, increased clinical experience and updated outcome data have led to its expanded use, including a range of glaucomas and angle presentations, previously deemed to be relatively contraindicated. The main benefits are a high degree of safety, ease, and speed compared to traditional filtering surgery and tube shunts. The increasing burden of glaucoma and expanding life expectancy has resulted in demand for well-trained surgeons. In this article, we discuss the results of trabectome surgery in standard and nonstandard indications. We present training strategies of the surgical technique that include a pig eye model, and visualization exercises that can be performed before and at the conclusion of standard cataract surgery in patients who do not have glaucoma. We detail the mechanism of enhancing the conventional outflow pathway and describe methods of visualization and function testing.

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Preclinical Investigation of Ab Interno Trabeculectomy Using a Novel Dual-Blade Device

Cited by 156 publications

References 14 publications

Safety and Efficacy of Microinvasive Glaucoma Surgery

Safety and Efficacy of Microinvasive Glaucoma Surgery

Microinvasive glaucoma surgery: an evidence-based assessment

Training strategies and outcomes of ab interno trabeculectomy with the trabectome

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