MIGS - BANG - Dr. Amit Porwal скачать в хорошем качестве

MIGS - BANG - Dr. Amit Porwal

The phrase ‘MIGS’ was coined by Dr. Ike Ahmed in 2009. MIGS has revolutionized glaucoma management with minimal tissue trauma, good post-operative recovery, and improved patient satisfaction. There are various approaches for MIGS procedures viz. trabecular meshwork, subconjunctival space, suprachoroidal space, ciliary body. BANG (Bent ab-interno Needle Goniectomy) increasing aqueous outflow from trabecular meshwork and Schlemm’s canal by tissue removal through excision of the trabecular meshwork tissue. It bypasses the trabecular meshwork and form a direct pathway to Schlemm’s canal for 3-4 or more clock hours. It can be performed combined with cataract surgery or as a stand-alone procedure in phakic, aphakic or pseudophakic patients. Ideal candidate for Phaco plus BANG procedure for beginners is one who is having mild to moderate open angle glaucoma, whose goal is to decrease IOP by 20-30% or in mid-teens, and / or to reduce the number of glaucoma medications. BANG is the only low cost MIGS procedure. All you need is a 25G hypodermic needle (5/8 inch) and a needle holder to bend the tip. A goniotome is fashioned by bending the distal 1 mm of the needle toward the bevel at about 75 to 80 degree angle and is then used to perform a goniectomy for about 120 degrees using a gonioprism. Published literature depicts reduction of IOP and number of anti-glaucoma medications after Phaco plus BANG by 30-50%. Thus MIGS – BANG provides safe new options for IOP reduction and reducing the number of anti-glaucoma medications. It has low risk, low cost and is effective. Because of the above factors BANG has gained popularity in developing countries.