Novel Glaucoma Devices for the Control of Intraocular Pressure: A Review

Main Article Content

Mirian Man Hin Dang
Harry Dang

Keywords

Open-angle glaucoma, iStent, Minimally-invasive glaucoma surgery, Ex-PRESS glaucoma implant, Intraocular pressure, Cataract surgery

Abstract

Objective: To review and summarize the published literature and clinically relevant information about emerging or novel surgical techniques used for lowering intraocular pressure in the treatment of open-angle glaucoma. The secondary objective is to describe the procedures and devices in the context of the appropriate theoretic effects, patient population, advantages, and disadvantages. The two devices that will be discussed in this review are the Ex-PRESS mini glaucoma shunt (Alcon Inc. Hunenberg, Switzerland) and the iStent trabecular micro-bypass stent (Glaukos Corp. California, USA)

Methods: Literature searches of the Cochrane Library and the Pubmed databases were conducted up to August 2014 with no language or date restrictions. These searches retrieved 65 citations, of which 10 were deemed topically relevant.

Results: Both devices studied in this review show a statistically significant reduction in intraocular pressure and, in some studies, glaucoma medications use. Various rates and types of complications were reported depending on the technique used.

Conclusions: The novel glaucoma devices studied all demonstrate promise as treatment options to reduce intraocular pressure in the treatment of glaucoma. It is not possible to conclude whether these two novel techniques are inferior, equal to, or superior to traditional surgeries such as trabeculectomy. The studies provide the basis for future randomized or comparative trials of glaucoma surgical procedures and other novel techniques.