Sight Sciences announced that a review of the history of canal surgery in glaucoma, by Jaime Dickerson, PhD, and Reay Brown, MD, has been published in Current Opinion in Ophthalmology.
The review, titled “Circumferential canal surgery: a brief history,” highlights the long history of microinvasive glaucoma surgery (MIGS) which has changed the course of treatment and prognosis for patients with glaucoma particularly over the past 10 to 15 years. MIGS procedures are effective, create little trauma to ocular tissues, and allow a rapid patient recovery with a low complication rate. While the term “MIGS” was coined just under a decade ago, minimally invasive glaucoma surgery was pioneered over 80 years ago with the work of Dr. Otto Barkan who first performed clear corneal or “ab interno” angle surgery in 1936. There has been a revolution in minimally invasive glaucoma surgery technology since Dr. Barkan’s very first goniotomy using a metal blade.
Innovations in sophisticated microcatheter technology applied to glaucoma have allowed for minimally invasive surgical treatment of the entire conventional outflow pathway through either circumferential trabeculotomy or circumferential viscodilation of the distal drainage pathway including Schlemm’s Canal and the collector channels. Drs. Dickerson and Brown review the extensive data in the scientific and medical literature that provide positive support for the distinct mechanisms of action of both circumferential trabeculotomy and circumferential viscodilation which together encompass more than 1,000 patients.
Published research has demonstrated that the trabecular meshwork accounts for approximately 60-70% of the outflow resistance while Schlemm’s canal and the distal collector channels make up approximately the other 30-40% of outflow resistance so a surgical solution that could address all three sources of outflow resistance would be desirable.(1) Most recently, the combination of these two procedures performed sequentially from an ab interno approach has been made possible with the company’s OMNI Surgical System.
“The OMNI procedure allows surgeons to treat all three points of resistance—the trabecular meshwork, Schlemm’s canal, and the distal collector system—with a single operation. This achieves a maximal impact with minimal risk and no implant is left behind. The OMNI system also allows surgeons to titrate the extent of angle treated based on the clinical goals. The success of this approach is supported by an abundance of historical data and a growing number of peer-reviewed studies,” said Dr. Reay Brown, Chief Medical Officer of Sight Sciences and co-author of the review.