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Minimally invasive glaucoma surgery (MIGS) has been developed for all drainage pathways in glaucoma treatment. Besides implants overriding the resistance in the trabecular meshwork (iStent®, iStent Inject® [both Glaukos Germany GmbH, Wiesbaden, Germany], Hydrus Microstent® [Ivantis, Irvine, CA, USA]) and draining to the suprachoroidal space (Cypass Micro Stent® [Alcon Laboratories, Inc., Fort Worth, TX, USA], iStent Supra® [Glaukos Germany GmbH]), surgeons can further drain aqueous humor into the subconjunctival space with a transscleral MIGS implant (XEN45® [Allergan Plc., Dublin, Irland]). The XEN45® is a gelatine tube 6 mm in length, which is implanted ab interno via a small corneal incision through the sclera. Additional aqueous humor is drained from the anterior chamber via the tube and filtered in a filter cushion in order to sink the total drainage resistance. The internal diameter of the lumen of the implant is 45 µm, therefore a passive resistance is present for prevention of postoperative hypotension. The by-passed aqueous humor forms a conjunctival bleb. Although the first study results are promising in terms of efficacy and safety, further studies are necessary before a clear picture of the effectiveness, safety, advantages and disadvantages of the gelatine tube can be drawn.
This article was published in the following journal.
Name: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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Diagnostic and therapeutic procedures that are invasive or surgical in nature, and require the expertise of a specially trained radiologist. In general, they are more invasive than diagnostic imaging but less invasive than major surgery. They often involve catheterization, fluoroscopy, or computed tomography. Some examples include percutaneous transhepatic cholangiography, percutaneous transthoracic biopsy, balloon angioplasty, and arterial embolization.
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