Modern Technologies of Open-Angle Glaucoma Surgery

Currently, glaucoma surgery has become a major technique. Surgery is a method of choice in open-angle glaucoma, especially in those cases when conservative and laser treatments have no effect, as well as if glaucoma is inaccessible or a patient has low treatment compliance. In this review the authors give the information about the development of main glaucoma surgery directions, such as removal of pupillary block, the anterior chamber fistulization, the reduction of intraocular fluid production. Drainage surgery, its history and modern technical devices have been characterized in detail. The design of drainage devices has been improved towards their size reduction, extension of filtration area and the development of valve mechanisms. Indications for their implementation in open-angle glaucoma treatment, and the factors contributing to a successful treatment have been discussed. There have described early and late complications of microdrainage and paid particular attention to obliteration of developed outflow pathways, being the main problem as they reduce the effect of filtering and draining operations. The authors have presented a number of advanced micro-invasive technologies, both used in clinical practice (Ex-PRESS™ mini-shunt, Trabectome™, iStent, canaloplasty and viscocanalostomy), and those being under clinical study — SOLX Gold Micro-Shunt, CyPass, Hydrus™ Microstent a canalicular scaffold, AqueSys Microfistula Implant. There has been presented the information on design and technology of these devices with their detailed classification based on the differences in their mechanism of action, operative approach type and material used.

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Svetozarskiy S.N., Maslennikova Y.А., Anikeeva M.V. Modern Technologies of Open-Angle Glaucoma Surgery. Sovremennye tehnologii v medicine 2014; 6(1): 102