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Combining Mechanisms: Viscodilation, Trabeculotomy, and Hydrus Implantation

Inder Paul Singh, MD

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This video describes combining various MIGS procedures with complementary mechanisms of action. This patient was on four medications with IOP in the upper 30s and moderate progressing OAG. I didn't want to wait for surgery even with concerns over COVID-19. I was tempted to perform a trabeculectomy, but I wanted to decrease the potential for adverse events which would cause the patient to have to return to the office more often. I therefore chose 360-degree viscodilation, 180-degree trabeculotomy, and Hydrus implantation to maximize conventional outflow. I could always consider a subconjunctival surgery if needed in the future. Postop day 1 IOP was 14 mmHg and with 20/30 visual acuity.

Posted: 4/22/2020

Keywords:

Hydrus Microshunt (Ivantis)

•

Microinvasive Glaucoma Surgery (MIGS)

•

Microinvasive Glaucoma Surgery (MIGS)

•

Trabeculotomy

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Combining Mechanisms: Viscodilation, Trabeculotomy, and Hydrus Implantation

Inder Paul Singh, MD

This video describes combining various MIGS procedures with complementary mechanisms of action. This patient was on four medications with IOP in the upper 30s and moderate progressing OAG. I didn't want to wait for surgery even with concerns over COVID-19. I was tempted to perform a trabeculectomy, but I wanted to decrease the potential for adverse events which would cause the patient to have to return to the office more often. I therefore chose 360-degree viscodilation, 180-degree trabeculotomy, and Hydrus implantation to maximize conventional outflow. I could always consider a subconjunctival surgery if needed in the future. Postop day 1 IOP was 14 mmHg and with 20/30 visual acuity.

Posted: 4/22/2020

Keywords:

Hydrus Microshunt (Ivantis)

•

Microinvasive Glaucoma Surgery (MIGS)

•

Microinvasive Glaucoma Surgery (MIGS)

•

Trabeculotomy

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