Minimally invasive glaucoma surgery (MIGS) has been a buzzword in glaucoma management for years, offering patients with mild to moderate glaucoma a middle ground between topical drops and filtration surgery. Today, more than 15 different options grace surgical suites across the globe.1 Yet another device, the Miniject (iStar Medical), has hit the clinical trial scene in Europe. The Miniject is a 5mm long device made of porous silicone that improves aqueous outflow to the suprachoroidal space, according to the study.

Researchers in India and Panama recently implanted the device, as a stand-alone procedure, in 25 primary open-angle glaucoma eyes. The average baseline status was IOP of 23.2mm Hg and an average of 2.0±1.1 IOP-lowering medications.

During follow-up, the researchers found the device led to a mean drop in IOP of 39.1% six months post-op. Medication use was down as well, to a mean of 0.3±0.7 medications at the six-month follow-up. Of the 24 eyes seen at that visit, 87.5% were medication free, and 95.8% maintained at least a 20% reduction in IOP, the researchers wrote in the study.

Although no serious adverse effects were noted, eight patients experienced anterior chamber inflammation, six had elevated IOP, three noted a drop in visual acuity and three had hyphema. None of the patients required further surgery by the six-month follow-up.

While these are promising findings, the device has a long road of clinical trials ahead, and US doctors may have to wait years before—and if—it becomes available stateside.

1. Caywood R. MIGS Madness: An atlas of options. Rev Optom. 2018;155(7):44-54.

2. Denis P, Hirneiß C, Reddy KP, et al. A first-in-human study of the efficacy and safety of Miniject in patients with medically-uncontrolled open angle glaucoma (STAR-I). Ophthalmol Glaucoma. June 20, 2019. [Epub ahead of print].