New World Medical’s VIA360™ Surgical System recently received 510(k) clearance from the FDA for the delivery of viscoelastic fluid during ophthalmic surgery. It is also indicated to cut trabecular meshwork tissue during trabeculotomy procedures, and can be used in combination with cataract surgery or as a standalone procedure. The system is designed with features that enhance the overall surgical experience, addressing the limitations of current catheter-based devices.
Ophthalmic surgeon and glaucoma specialist Inder Paul Singh, MD, President of the Eye Centers of Racine & Kenosha, Wisconsin, is an early adopter of the device. To begin with, he told The Ophthalmologist, “for the staff, the set-up time with the VIA360™ Surgical System is extremely efficient. It’s very easy to prime with the viscoelastic, and it’s very ergonomic. Whether you have small or large hands, it’s intuitive to wheel. With just a single entry, the scroll wheel and button allow for smooth catheter extension and retraction. The device can also go through a main incision or a paracentesis, and go up to 360 degrees without having to come out of the eye. A surgeon, if one prefers, can change direction after the first 180 degrees as well providing versatility to the procedure with various techniques.”
Among the devices’ features is the proprietary ActiveInject™ Technology, which enables on demand viscoelastic delivery independent of catheter movement. The Smart Prime system optimizes viscoelastic volume (over 100+ µL) to maximize efficiency throughout the procedure. “What makes this unique is that the device releases viscoelastic not just at the tip, but also through the micro-channels along the actual catheter posterior to the tip. So, you have controlled viscoelastic delivery, both forward and tangentially. It gives you the control to press as much as you want, and not only how much viscoelastic you want to deliver , but also when you want to deliver it.”
Singh continues: “It allows you to perform a trabeculotomy very efficiently as well. The catheter allows you to cut the trabecular meshwork if you want to, whether it’s 360, 180, or 90 degrees. You have that control and flexibility to perform as much of a GATT-type procedure as you like.”
While it is early days in terms of assessing patient feedback and outcomes, Singh notes that “I’m seeing good results so far with patients that require only delivery of viscoelastic – no cutting. You don’t have to do a cutting-type procedure at the same time to get significant effectiveness.”
Advice for surgeons
In this age of minimally invasive glaucoma surgery and interventional glaucoma, “we’re coming to the understanding that the earlier we intervene, the better chance we have of optimizing treatment,” explains Singh. “It’s also important to note that there isn’t just one surgery, one procedure, that’s going to last forever and be a cure-all. I think it’s really important try new things, to be open minded to different technologies, different procedures. Remember, the skill-set you already possess allows you to try different devices.”
There is, of course, a learning curve associated with all new devices, Singh adds. “The VIA360™ Surgical System is very efficient and intuitive. So, get your hands on experience in the wet lab, hold the device a few times, and then try a few cases. You can do a good three to four or five cases in a day, at least. And you’ll realize between the first and the fourth or fifth case, all of a sudden there’s a significant difference in your comfort level, in your muscle memory, visual and tactile cues, which all makes a difference.”
Singh concludes, “For me, the technology elevates the efficiency of the procedure by allowing me to deliver viscoelastic exactly where and when it’s needed, with complete control at my fingertips.”
