Leave No Thing Behind

The need to avoid compliance issues associated with glaucoma topical medications is well known. The need for a safer alternative to the standard in surgical treatment of glaucoma – trabeculectomy – is clear. Addressing both demands, Sanoculis Ltd has added a new surgical device and technique into the minimally invasive glaucoma surgery (MIGS) armamentarium.

Minimally invasive micro sclerostomy (MIMS®) is an efficient, safe, fast and simple surgical technique that enables controlled fluid flow without leaving behind stitches, implants or patches. Resulting in a creation of a sclero-corneal drainage channel, the procedure ensures long-lasting controlled fluid flow with minimal complications – with the ultimate benefit of reduced intraocular pressure.

MIMS® is much less traumatic to the surrounding tissue than conventional glaucoma surgery – but what’s involved? First, the surgeon creates a side port and fills the anterior chamber with a viscoelastic agent to protect the iris and prevent hypotony. Next, the sub-Tenon’s is filled with the viscoelastic to create room for the rotating cutting tool protrusion. After inserting the surgical instrument through the side port to the angle (ab-interno), the surgeon presses the MIMS® foot pedal and a rotating cutting tool creates the drainage channel, and withdraws automatically along with the cylinder of sclero-corneal tissue that has been removed. The intraocular fluid drains from the anterior chamber into the subconjunctival space, where it is reabsorbed into the surrounding blood vessels.

The surgery is super-efficient; it takes 2-3 minutes and can be carried out in outpatient clean-room clinics, minimizing operatingroom time, shortening the hospitalization period, and saving overall costs. Due to its simplicity, the procedure can be performed by a wide range of ophthalmologists – and can be easily combined with cataract surgery, resulting in further time and cost savings.

The MIMS® device consists of a disposable surgical instrument and multi-use controller, which is designed to activate the instrument, removing the tissue with a rotary motion. The activation component comprises a footswitch and controller unit with a graphic user interface, an autoclavable motor and hose, and a stand.

As MIMS® is stent-less and leaves nothing behind, it not only lowers the risk of post-surgical complications but also keeps future therapeutic options very much in play for patients.

Thanks to all these benefits, MIMS®, already CE-marked, has the potential to become a new paradigm for first-line filtering surgery in glaucoma.