AAO 2023: Suprachoroidal outflow enhancement without implantable hardware: surgical technique and clinical results of a novel supraciliary MIGS

News
Article

Investigators found that ab-interno implantation of a supraciliary allograft bio-tissue successfully reduced intraocular pressure with comparable safety to other minimally invasive glaucoma surgical procedures

A woman undergoes screening before eye surgery.  Image credit: ©romaset – stock.adobe.com

Researchers reported on a new micro-interventional technique to enhance suprachoroidal outflow in patients with glaucoma at the American Academy of Ophthalmology annual meeting. Image credit: ©romaset – stock.adobe.com

Tsontcho (Sean) Ianchulev, MD, MPH, and colleagues reported on a new micro-interventional technique to enhance suprachoroidal outflow in patients with glaucoma at the American Academy of Ophthalmology annual meeting in San Francisco, California.

They found that ab-interno implantation of a supraciliary allograft bio-tissue successfully reduced intraocular pressure (IOP) with comparable safety to other minimally invasive glaucoma surgical (MIGS) procedures. Dr Ianchulev is Professor, Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, andDirector, Ophthalmic Innovation and Technology Program, New York Eye and Ear Infirmary of Mount Sinai and inventor of the technology.

In this project, the researchers evaluated a new microinterventional technique for suprachoroidal outflow enhancement where no implantable hardware is used but only scaffolded bio-tissue from modified scleral allograft for supraciliary cleft reinforcement. Following the implantation, the changes in the patients’ IOP and the number of medications used were monitored from baseline out to 12 months.

The researchers reported that the procedure achieved significant and sustained IOP lowering after a combined cataract and supraciliary outflow intervention in 45 subjects through 12 months of follow-up. The safety profile of the device was similar to that of other trabecular MIGS devices. The bio-conforming allograft tissue and the lack of exogenous implantable hardware material are also important factors for endothelial health and safety.

A second study and abstract by Iqbal Ahmed et al. reported on the surgical feasibility and clinical outcomes of dual outflow ab-interno MIGS intervention with combined supraciliary bio-stenting and trabeculorhexis goniotomy using a new super-elastic memory-shaped Nitinol device (T-Rex, Iantrek, Inc) designed for continuous guided gonio-intervention. The combined dual outflow MIGS procedure was well tolerated and with good surgical results in the setting of cataract surgery.

Co-coauthors in the clinical studies included Iqbal K Ahmed, MD; Ernesto A. Calvo MD; Gautam Kamthan, MD; Farrell C. Tyson, II, MD, Arsham Sheybani, MD; Lautaro Vero, MD; and Sean Ianchulev, MD, MPH.

References

1. Sean Ianchulev, MD, MPH; Iqbal K Ahmed, MD; et al. Suprachoroidal Outflow Enhancement Without Implantable Hardware: MIGS Surgical Technique and Clinical Results on a Novel Supraciliary Intervention. Paper presented at: American Academy of Ophthalmology, 3-6 November, 2023; San Francisco, California, United States of America.
2. Iqbal K. Ahmed, MD; Guatam Kamthan, et al. Dual Pathway MIGS Surgery for Combined Trabecular and Suprachoroidal Outflow Augmentation: First-in-Human Feasibility Study. Paper presented at: American Academy of Ophthalmology, 3-6 November, 2023; San Francisco, California, United States of America.

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Christine Curcio, PhD, of the University of Alabama at Birmingham Heersink School of Medicine, shares histology update and revised nomenclature for OCT with Sheryl Stevenson of the Eye Care Network and Ophthalmology Times
SriniVas R. Sadda, MD, FARVO, shares key points from his retina presentation at the International SPECTRALIS Symposium
Robert Sergott, MD, describes fluorescence lifetime imaging ophthalmoscopy (FLIO) and the International SPECTRALIS Symposium – And Beyond (ISS) in Heidelberg, Germany.
Rayaz Malik, MBChB, PhD, a professor of medicine at Weill Cornell Medicine - Qatar, spoke with Ophthalmology Times Europe about his presentation. It's titled "An eye on neurodegenerative diseases: Challenging the dogma" at the International SPECTRALIS Sympsoium. In conversation with Hattie Hayes, Ophthalmology Times Europe
Anat Loewenstein, MD, describes her presentation on remote imaging for age-related macular degeneration and geographic atrophy at the International SPECTRALIS Symposium, in conversation with Hattie Hayes of Ophthalmology Times Europe
Tyson Brunstetter, OD, PhD, a US Navy Aerospace Optometrist at the NASA Johnson Space Center in Houston, Texas, shares key takeaways from his keynote at the International SPECTRALIS Symposium (ISS)
Rayaz Malik, MBChB, PhD, shares his presentation, titled An eye on neurodegenerative diseases: Challenging the dogma, at this year's International SPECTRALIS Symposium
At the Retina World Congress, Siegfried Priglinger, MD, speaks about ensuring the best outcomes for preschool-aged patients
At the 2025 ASCRS meeting, Robert Ang, MD said small aperture IOLs can benefit all patients, especially those with complex corneas or who have undergone previous corneal refractive surgery
Viha Vig, MBChB graduate student at the University of Auckland, New Zealand, discusses her poster presentation on the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia.
© 2025 MJH Life Sciences

All rights reserved.