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Subspecialties Glaucoma, Business and Innovation

Cutting it Fine – in a Good Way

sponsored by MST

Meet the TrabEx Pro from MST – an extension to the leading TrabEx line of goniotomy blades from a company continually investing and innovating in the glaucoma space. TrabEx Pro is a surgical instrument designed specifically for the complete removal of diseased trabecular meshwork.

MST’s glaucoma focus is to take traditional goniotomy surgery to the next level. In goniotomy, an incision is made in the trabecular meshwork, allowing for aqueous to access the collector channels of Schlemm’s canal and drain via the natural outflow system. One concern that surgeons have expressed with goniotomy is that incomplete removal of trabecular meshwork may allow remaining tissue to reactuate and reocclude the aqueous outflow. TrabEx Pro includes innovative features that may facilitate a more complete excision of diseased trabecular meshwork. 

What are the unique features that allow the TrabEx Pro to fully and cleanly remove the required tissue? First, the device features a trapezoidal blade head with laser-honed serrated blades. The trapezoidal orientation of the blades allows for a custom cut for each individual patient and each section of tissue, which often varies (1). In narrow sections of trabecular meshwork, the tissue is cut at a narrow section of the blade. In wider sections of trabecular meshwork, the tissue passes further up the graduating blades and is cut at a wider section, leaving minimal amounts of tissue behind. While other blades for goniotomy offer a one-size-fits-all approach, the TrabEx Pro can offer a custom cut for each specific situation. 

The TrabEx Pro is also completely polished on the distal end, which can provide gentle contact with tissues that are not intended to be removed. The footplate of the blade is rounded and comes down to 66 microns at the distal end, allowing for high levels of precision and surgical control. What’s more, the rounded distal heel of the blade head is contoured to the arch of the eye.

But perhaps the most important aspect of the TrabEx Pro is the way it is compatible with all phacoemulsification platforms. The ergonomic handle is designed to provide comfort and control for the user and features a blade directional indicator that clearly defines the orientation of the device. 

Finally, the TrabEx Pro boasts a silicone sleeve that eliminates the need to change incision sizes when performing a combined goniotomy and cataract procedure. Improvements have also been made to the ergonomics of the hand piece, which provide maximum user comfort to every surgeon for every procedure.

The TrabEx Pro is pending 510(k), and not available for sale within the United States. 

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  1. MH Kuehn et al., “Circumferential trabecular meshwork cell density in the human eye,” Exp Eye Res, 205, 108494 (2021). PMID: 33596442.
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