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    Glaucoma micro-stent’s 2-year data promising

    Atlanta—A micro invasive glaucoma surgical (MIGS) device (CyPass Micro-Stent, Alcon) can safely lower IOP in patients with glaucoma for at least 2 years, researchers said.

    “The MIGS devices are a breakthrough in glaucoma therapy and this is another step down the road,” said Reay Brown, MD, Atlanta Ophthalmology Associates, Atlanta.

    Related: Managing ocular surface disease in patients with glaucoma

    Dr. Brown is a co-author on a paper describing the 2-year data from the COMPASS trial of the micro-stent that was published in Ophthalmology.

    The FDA approved the micro-stent earlier this year for treatment of mild to moderate primary open-angle glaucoma (POAG) in conjunction with cataract surgery. It is the first direct competitor to a previous stent (iStent Trabecular Micro-Bypass Stent, (Glaukos), which the FDA approved 4 years ago for the same indication.

    MIGS devices offer an advantage over ocular hypotensive medication, tube shunts, and trabeculectomy for POAG, Dr. Brown said. Unlike eye drops, they do not depend on patients to apply them regularly. The procedure to implant MIGS is shorter and as of now, complications appear much less common than with trabeculectomy and tube shunts.

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    “The iStent has already shown the way, and we’ll see how the CyPass fits in,” said Dr. Brown. “In my practice, I do an iStent on anybody who is having cataract surgery and is being treated for glaucoma.”

    In contrast to the iStent, which creates a bypass through the trabecular meshwork, the CyPass is implanted in the supraciliary space. “It’s good to have options,” said Dr. Brown.

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    The CyPass measures 6.35 mm in length with a 510 µm external diameter. Surgeons implant the device with an applier using direct gonioscopy in a procedure initiated by a bluntly dissected plane between the ciliary body and the sclera.

    Composed of polyimide material, the device assumes the curvature of the applier guidewire to follow the sclera contour along the supraciliary space. Once retention features are engaged, the surgeon retracts the guidewire and withdraw the applier. The micro-stent remains in place indefinitely.

    Testing efficacy

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