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    MIGS driving the device market



    Glaukos created the market for MIGS devices with its iStent. Approved by the FDA in 2012, the device generated good revenues in 2013 and achieved reimbursement in every Medicare region.

    Just 1 mm long, the iStent is the smallest medical device known to be implanted in the human body, said Bruce Nogales, chief corporate development officer. The company is already working on two follow-up devices.

    Next up in the Glaukos pipeline is the iStent inject, another trabecular meshwork bypass device.  Where a single iStent is pre-loaded in a tactile inserter, two iStent injects are pre-loaded in an auto-injection system. An IDE study for combination use with cataract surgery is already underway, a second IDE study for phakic use is set to begin later this year. Glaukos projects approval by 2017.

    Farther down the pipeline is the iStent supra, which drains to the suprachoroidal space. An IDE study is currently under way using a single-stent insertion mechanism. The company projects FDA approval in 2018.

    “The iStent supra will give us another treatment mechanism to lower IOP,” Nogales said. “We want to get meaningful technologies to the ophthalmologist to help save sight for patients.”

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