Objective:
To discuss the role of minimally invasive bleb surgery (MIBS) in glaucoma care and review investigational devices under development.
Key Findings:
- MIBS could bridge the gap between traditional filtering surgery and angle-based MIGS.
- Current MIBS options include the Xen 45 gel stent and investigational devices like the PreserFlo MicroShunt.
- Emerging nonimplant approaches, such as Aqualumin and Hexiris's Obi Ex, are also being developed.
Interpretation:
MIBS technologies may expand treatment options for glaucoma patients, particularly those at high risk of vision loss, by providing effective pressure reduction with improved safety profiles.
Limitations:
- Long-term success of MIBS depends on subconjunctival healing and the use of antifibrotic agents.
- Current MIBS outcomes have not consistently matched those of traditional surgeries like trabeculectomy.
Conclusion:
MIBS represents a promising advancement in glaucoma treatment, with multiple devices in development that could enhance patient care.
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