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Combining Mechanisms: Viscodilation, Trabeculotomy, and Hydrus Implantation

  Channels: Glaucoma | Posted 4/22/2020

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.

Hydrus Microshunt (Ivantis) • Microinvasive Glaucoma Surgery (MIGS) • MIGS • trabeculotomy

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