Minimally Invasive Micro Sclerostomy (Mims) In Advanced Glaucoma Patients

Published 2022 - 40th Congress of the ESCRS

Reference: PO399 | Type: ESCRS 2022 - Posters | DOI: 10.82333/d1k8-0d43

Authors: Meishar Meisel* ¹ , Isaac Hindi ¹ , Eran Berkowitz ¹ , Beatrice Tiosano ¹

¹Ophthalmology,hillel yaffe medical center,Hadera,Israel

Purpose

The ab-interno Minimally Invasive Micro Sclerostomy (MIMS) stent-less sub conjunctival filtration procedure is an alternative method of aqueous humor drainage created by forming a scleral tunnel between the anterior chamber and the sub conjunctival space. We evaluated the safety and efficacy of the MIMS® procedure in uncontrolled advanced glaucoma patients on maximum tolerated medical therapy.

Setting

Study participants were adults with advanced open angle glaucoma, operated by a single surgeon in a tertiary glaucoma Unit, Hillel Yaffe Medical Center, Hadera, Israel.

Methods

Single-center, consecutive, non-comparative case series study of advanced uncontrolled open-angle glaucoma patients that underwent MIMS® procedure between December 2020-June 2021. 8 patients (8 eyes) that underwent the MIMS® procedure were examined at day 1 and followed for 1 week and for 1, 3, 6, and 12 months. Patients who underwent secondary glaucoma procedures were considered as failure. Procedure-related complications and adverse events were assessed.

Results

Eight MIMS procedures were performed. Scleral tunnels were achieved successfully in all cases. No device malfunctions, intraoperative complications, or serious adverse events were reported. Three patients presented with Choroidal effusion 1-2 weeks following the procedure which resolved with medical treatment, 1 patient presented with retinal detachment 6 months post-operatively. Mean IOP at baseline was 24.3±10.3 mmHg. The number of IOP lowering medications was 4.3 ± 1.2. After 12 months of follow-up, mean IOP was 19.6±9.6 (p=0.42) and the number of IOP lowering medications was 3.2±1.6 (p=0.16). Two patients underwent an additional secondary glaucoma procedure during follow-up period (Express implant and Cyclophotocoagulation).

Conclusions

Our initial results suggest that the MIMS® is a simple procedure with short term efficacy. IOP values at 12 months post-operatively were not statistically significant from baseline levels. However, there was a tendency to maintain these IOP values with fewer IOP-lowering medications. Two of the patients did not require any IOP-lowering medications at 12 months post-operatively. The limitations of this pilot study was the small number of study patients. Larger studies with a longer follow up are warranted for further evaluation of the safety and efficacy of the MIMS procedure.