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J. Morgan Micheletti, MD
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Dr. Micheletti explains that this MIGS combination procedure is one of the many he utilizes for patients with mild glaucoma because it leaves much of the trabecular meshwork untouched and the canal in tact for possible future needs or advances in angle surgery. He says much of the canal’s physiology is dependent on pulsatile flow to help move fluid into the collector channels, so augmenting that ability with viscodilation while bypassing the area of highest resistance (the trabecular meshwork, in particular the juxtacanalicular tissue) with the iStent (Glaukos) has been beneficial to his patients.
He describes the highlights of this surgical video:
1. The Streamline (New World Medical) device effectively delivers OVD into the canal.
2. The iStents are in the correct position (see the burst of OVD).
3. The iStent can handle a large amount of force and flow, as 7 uL of OVD pushed next to it didn’t dislodge it at all.
4. EDOF IOLs can still be a good option for patients with mild to moderate glaucoma.
Financial Disclosures: Consultant (Glaukos, New World Medical)
Posted: 8/21/2023
J. Morgan Micheletti, MD
Dr. Micheletti explains that this MIGS combination procedure is one of the many he utilizes for patients with mild glaucoma because it leaves much of the trabecular meshwork untouched and the canal in tact for possible future needs or advances in angle surgery. He says much of the canal’s physiology is dependent on pulsatile flow to help move fluid into the collector channels, so augmenting that ability with viscodilation while bypassing the area of highest resistance (the trabecular meshwork, in particular the juxtacanalicular tissue) with the iStent (Glaukos) has been beneficial to his patients.
He describes the highlights of this surgical video:
1. The Streamline (New World Medical) device effectively delivers OVD into the canal.
2. The iStents are in the correct position (see the burst of OVD).
3. The iStent can handle a large amount of force and flow, as 7 uL of OVD pushed next to it didn’t dislodge it at all.
4. EDOF IOLs can still be a good option for patients with mild to moderate glaucoma.
Financial Disclosures: Consultant (Glaukos, New World Medical)
Posted: 8/21/2023
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