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Supraciliary Microstent Implantation

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Title: Supraciliary Microstent Implantation
Author (s): Tanner Ferguson, MSIV, University of South Dakota School of Medicine, Craig Chaya, MD, Moran Eye Center, University of Utah
Date: 09/24/17
Keywords/Main Subjects: MIGS (minimally invasive glaucoma surgery), glaucoma surgery, glaucoma
Diagnosis: POAG; Glaucoma
Description of Case: This video demonstrates the implantation of a CyPass microstent as a sole procedure by Craig Chaya, MD from the Moran Eye Center, University of Utah. Below is our surgical technique for implantation of the CyPass micro-stent and standard postoperative regimen.

Note: This video is best viewed in high resolution (720p).

Summary of the Case:
Notable Surgical Instruments

Surgical Technique

  1. Two clear corneal incisions are created; one superiorly and one temporally, approx. 90 degrees from superior paracentesis.
  2. OVD is instilled through superior incision to stabilize and maintain anterior chamber.
  3. OVD is injected onto surface of cornea as coupling medium between the cornea and lens.
  4. The patient’s head is tilted approximately 30 degrees away from the surgeon and the patient is instructed to look opposite the surgeon. The microscope is adjusted to a comfortable position.
  5. The gonioprism is placed on the surface of the cornea with the non-dominant hand.
  6. The guidewire is inserted through the primary temporal incision with the dominant hand.
  7. After the anterior chamber angle anatomy is identified, the surgeon aims for the scleral spur landmark.
  8. The guidewire is inserted directly below (posterior) the scleral spur and the micro-stent stent is inserted into the supraciliary space.
    1. Note: The microstent should guide through the space with minimal resistance. If the surgeon encounters resistance, the surgeon should consider adjustment or an alternative location.
  9. After the microstent is inserted, the surgeon taps on the proximal edge with the inserting device to secure placement and the retention rings on the device should be visible.
  10. The residual viscoelastic in the anterior chamber is removed with irrigation/aspiration.



Format: Video
Faculty Approval by: Craig Chaya, MD
Identifier: Moran_CORE_24341
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