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Subspecialties Glaucoma, Health Economics and Policy, Business and Innovation

Ever Evolving, Always Improving

The introduction of minimally invasive glaucoma surgery (MIGS) – the first generation iStent – back in 2008 signaled a big change in the way that we practiced glaucoma surgery and in the outcomes we were witnessing in patient safety and visual recovery. Since then, the MIGS philosophy has become pervasive; devices have been developed for every known target tissue in the aqueous fluid pathway and it feels like we hear about a novel device or new technique every year.

Figure 1. Ab externo implantation technique. (A)A traction suture is placed to aid in exposure. After the tip of the XEN45 stent is visualized, marked and retracted into the injector tip, (B) The injector enters the subconjunctival space and engages the sclera approximately 2 mm posterior to the limbus. (C) The XEN45 stent is deployed and visualized in the subconjunctival space. (D) A mirrored gonioscopic lens is used to confirm proper positioning of the stent.

Disclosures:
Allergan: Consult/Research
Glaukos: Speaker/Research
Optovue: Research
Olleyes: Research

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About the Author

Daniel Lee

Member of the Glaucoma Service at Wills Eye Hospital and a clinical instructor of ophthalmology at Sidney Kimmel Medical College, Philadelphia, USA.

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