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Over the last few years, there has been an explosion of new surgical treatments for glaucoma. They all promise maximum safety, minimal invasion, combined with good efficacy in the control of glaucoma. There are a range of ab interno interventions and devices that aim to increase aqueous outflow. The Trabectome (NeoMedix, USA) is designed to remove a large section of trabecular meshwork, exposing collector channels and increasing outflow. The iStent (Glaukos, USA) and Hydrus (Ivantis, USA) are both devices that are inserted into Schlemm's canal ab interno, bypassing trabecular meshwork resistance. The Xen implant (Aquesys, USA) is another ab interno device that is inserted through the trabecular angle into the subconjunctival space, creating an external drainage fistula similar in concept to a trabeculectomy. High intensity focused ultrasound (HIFU, Eyetechcare, France), a technology previously used successfully in the treatment of prostate cancer, has recently been adopted in glaucoma to ablate the ciliary body. In this issue of BJO, we look at another potential ‘gold mine’ for glaucoma treatment—the suprachoroidal space. There has been a resurgence of interest in exploring the potential of directing aqueous into the suprachoroidal space by means of ab interno drainage devices. Saheb and colleagues from Canada examined the CyPass Micro-Stent (Transcend Medical, USA) …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
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