Conventional glaucoma implants and the new MIGS devices: a comprehensive review of current options and future directions

Inês C.F. Pereira; Rosanne van de Wijdeven; Hans M. Wyss; Henny J.M. Beckers; Jaap M.J. den Toonder

doi:10.1038/s41433-021-01595-x

Conventional glaucoma implants and the new MIGS devices: a comprehensive review of current options and future directions

Inês C.F. Pereira, Rosanne van de Wijdeven, Hans M. Wyss, Henny J.M. Beckers, Jaap M.J. den Toonder (Corresponding author)

Research output: Contribution to journal › Review article › peer-review

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Abstract

Glaucoma is a progressive optic neuropathy that is the second leading cause of preventable blindness worldwide, after cataract formation. A rise in the intraocular pressure (IOP) is considered to be a major risk factor for glaucoma and is associated with an abnormal increase of resistance to aqueous humour outflow from the anterior chamber. Glaucoma drainage devices have been developed to provide an alternative pathway through which aqueous humour can effectively exit the anterior chamber, thereby reducing IOP. These devices include the traditional aqueous shunts with tube-plate design, as well as more recent implants, such as the trabeculectomy-modifying EX-PRESS^® implant and the new minimally invasive glaucoma surgery (MIGS) devices. In this review, we will describe each implant in detail, focusing on their efficacy in reducing IOP and safety profile. Additionally, a critical and evidence-based comparison between these implants will be provided. Finally, we will propose potential developments that may help to improve the performance of current devices.

Original language	English
Pages (from-to)	3202-3221
Number of pages	20
Journal	Eye
Volume	35
Issue number	12
Early online date	14 Jun 2021
DOIs	https://doi.org/10.1038/s41433-021-01595-x
Publication status	Published - Dec 2021

Bibliographical note

Funding Information:
Funding This research was financially supported by Chemelot Institute for Science & Technology (InSciTe) under grant agreement BM3.03 SEAMS.

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title = "Conventional glaucoma implants and the new MIGS devices: a comprehensive review of current options and future directions",

abstract = "Glaucoma is a progressive optic neuropathy that is the second leading cause of preventable blindness worldwide, after cataract formation. A rise in the intraocular pressure (IOP) is considered to be a major risk factor for glaucoma and is associated with an abnormal increase of resistance to aqueous humour outflow from the anterior chamber. Glaucoma drainage devices have been developed to provide an alternative pathway through which aqueous humour can effectively exit the anterior chamber, thereby reducing IOP. These devices include the traditional aqueous shunts with tube-plate design, as well as more recent implants, such as the trabeculectomy-modifying EX-PRESS{\textregistered} implant and the new minimally invasive glaucoma surgery (MIGS) devices. In this review, we will describe each implant in detail, focusing on their efficacy in reducing IOP and safety profile. Additionally, a critical and evidence-based comparison between these implants will be provided. Finally, we will propose potential developments that may help to improve the performance of current devices.",

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note = "Funding Information: Funding This research was financially supported by Chemelot Institute for Science & Technology (InSciTe) under grant agreement BM3.03 SEAMS. ",

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AU - Beckers, Henny J.M.

AU - den Toonder, Jaap M.J.

N1 - Funding Information: Funding This research was financially supported by Chemelot Institute for Science & Technology (InSciTe) under grant agreement BM3.03 SEAMS.

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N2 - Glaucoma is a progressive optic neuropathy that is the second leading cause of preventable blindness worldwide, after cataract formation. A rise in the intraocular pressure (IOP) is considered to be a major risk factor for glaucoma and is associated with an abnormal increase of resistance to aqueous humour outflow from the anterior chamber. Glaucoma drainage devices have been developed to provide an alternative pathway through which aqueous humour can effectively exit the anterior chamber, thereby reducing IOP. These devices include the traditional aqueous shunts with tube-plate design, as well as more recent implants, such as the trabeculectomy-modifying EX-PRESS® implant and the new minimally invasive glaucoma surgery (MIGS) devices. In this review, we will describe each implant in detail, focusing on their efficacy in reducing IOP and safety profile. Additionally, a critical and evidence-based comparison between these implants will be provided. Finally, we will propose potential developments that may help to improve the performance of current devices.

AB - Glaucoma is a progressive optic neuropathy that is the second leading cause of preventable blindness worldwide, after cataract formation. A rise in the intraocular pressure (IOP) is considered to be a major risk factor for glaucoma and is associated with an abnormal increase of resistance to aqueous humour outflow from the anterior chamber. Glaucoma drainage devices have been developed to provide an alternative pathway through which aqueous humour can effectively exit the anterior chamber, thereby reducing IOP. These devices include the traditional aqueous shunts with tube-plate design, as well as more recent implants, such as the trabeculectomy-modifying EX-PRESS® implant and the new minimally invasive glaucoma surgery (MIGS) devices. In this review, we will describe each implant in detail, focusing on their efficacy in reducing IOP and safety profile. Additionally, a critical and evidence-based comparison between these implants will be provided. Finally, we will propose potential developments that may help to improve the performance of current devices.

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Conventional glaucoma implants and the new MIGS devices: a comprehensive review of current options and future directions

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