Combined cataract surgery + iStent Inject W & Malyugin Ring скачать в хорошем качестве

Combined cataract surgery + iStent Inject W & Malyugin Ring

This is a case of a combined cataract and MIGS procedure with the implantation of iStent Inject W ("Wide") for moderate open-angle glaucoma. Phacoemulsification combined with microinvasive glaucoma surgery (MIGS) is my standard of care for cataract patients with mild to moderate glaucoma. MIGS procedures have demonstrated the ability to both reduce IOP and a patient’s need for medications, a significant benefit considering concerns regarding compliance rates among glaucoma patients. Glaukos has launched the iStent inject W in Europe in 2020, which is a slight modification of the iStent inject with a wide flange at its base. By intervening at the same time as cataract surgery, iStent inject W aim at delaying the need for alternative surgeries, reduce the number of follow-up appointments and potentially reduce medication costs. Proficiency with intraoperative gonioscopy is imperative to success with iStent implantation. When using the gonioscopy lens, do not press too firmly on the cornea, which can create striae and obstruct your view. A pupil expansion device was necessary in this small pupil surgical case. This is an important tool for cataract surgeons in situations where the pupil dilates poorly, including floppy iris syndrome. The Malyugin ring has four, equidistant loops which can "hook" the iris and dilate the pupil to 6 mm in diameter. The insertion of the Ring is performed using an injector. After the tip of the injector is inserted into the anterior chamber, the surgeon moves the thumb slide located on the injector distally to slowly inject the ring. The distal loop of the ring is attached to the iris first, as seen in this video. A Sinskey hook is used to position the remaining loops on the iris. Once the IOL is properly secured in the capsular bag, remove two loops at least, including the proximal one to extract the ring from the eye with microforceps. It is also possible to hook the proximal loop with the insertion device to fold back the Malyugin ring into the injector. #eyesurgery #cataract #iStent #iStentinject #trabecularbypass #MIGS #minimallyinvasiveglaucomasurgery #glaucoma #glaucomasurgery #cataractsurgery #eyesurgeon #Malyugin #Malyuginring #smallpupil #poordilation #combinedsurgery #ophthalmology