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The newest gel-made implants, miniature, flexible, atraumatic, present a step further in evolution of glaucoma surgery.
Long ago originated the idea of using gel implants that would modify traditional surgical approaches and that way, enable the treatment of glaucoma even in incipient and early phases.
SPECIAL HOSPITAL SVETI VID has introduced glaucoma surgery into new epoch, changing old, deficient surgical procedures.
Years ago, that was non-penetrating deep sclerotomy by aplication of SK gel, but now there are completely new gel implants used in surgical procedures, through miniature incision, that heals very quickly.
Via 2mm size opening in cornea, like mini-invasive cataract surgery, minuscule injector is placed, containing gel-implant, 6mm long, 45 microns wide, flexible. It is placed by “micro needle” into subconjunctival space where it remains. This technique “aids” the outflow of the aqueous in space out of the eye to be realeased through regular venous way.
The advantage of this method, in comparison with earlier methods, is that there is no opening of the eye, no implantation from the “outside”, but the whole procedure is inside the eye – ab interno.
This procedure is not adviced in terminal, far advanced stages with already a great nerve damage and significant visual field loss. Optimal effect of MIGS surgery is expected in incipient and moderatelly advanced stages, when usage of one eye medication can not prevail the disease, so called “unyielding glaucomas”, “resistant” to standard therapy even after the prior surgery that did not bring results.
The disease is to be closely followed, and for that purpose there are modern imaging methods, at first OCT (optical coherence tomography).
OCT is an objective indicator of degree of damage and enables comparative view with prior stages, therefore objectivelly shows whether the disease is advancing. In such case it is necessary to plan adequate surgical procedure, before serious and definite damages and loss of sight occurs.
In combined cataract and glaucoma cases, in planing cataract surgery, could be recommended combined procedure, during which Xen implant is placed to stabilize the eye pressure, and through the same incision intraocular lens is implanted. The incision is small, self-healing. There is no staying in the hospital.