Physicians Interviews

ABiC: A New MIGS on the Block
Mark J. Gallardo, MD
EL Paso Eye Surgeons, USA

In comparing the preliminary data for ABiC against the published data for the various MIGS devices, ABiC appears to be comparable, if not more effective, than other MIGS procedures. According to Dr. Gallardo, the reason is that ABiC is the only MIGS procedure that addresses all aspects of the eye’s outflow system, rather than just some aspects.

ABiC: Introducing A New MIGS
Mark J. Gallardo, MD
EL Paso Eye Surgeons, USA

According to Mark J. Gallardo, ABiC has worked so well to control his patients’ IOP and to reduce their medication load that it has become his “go-to” procedure for patients requiring (glaucoma) surgical intervention.

ABiC: An Evolution of Canaloplasty
Mahmoud A. Khaimi, MD
Dean McGee Eye Institute, USA

In this video interview, US glaucoma surgeon Dr. Khaimi addresses his experience with Canaloplasty. One of the early adopters of Canaloplasty, he has performed more than 1000 procedures. He is currently pioneering the clinical development of ABiC, an ab-interno MIGS procedure derived from Canaloplasty.

ABiC: A New, Comprehensive MIGS
Mahmoud A. Khaimi, MD
Dean McGee Eye Institute, USA

Canaloplasty expert Mahmoud A. Khaimi, MD, describes the advent of ABiC, which is Canaloplasty performed via an ab-interno approach to Schlemm’s canal. Performed with the speed and efficiency of a MIGS device insertion, according to Dr. Khaimi ABiC offers a subtle but significant refinement of traditional ab-externo Canaloplasty and avoids manipulating the conjunctiva.

Webinars

ABiC Webinar: A New MIGS on the Block?
AAO 2016
Mark J. Gallardo, MD
EL Paso Eye Surgeons, USA

In this webinar, Dr. Mark J. Gallardo addresses his 12-month data for ABiC in mild-moderate POAG patients. Based on his results to date, ABiC is effective at reducing the medication burden in patients with controlled POAG, while at the same time maintaining IOP. It is also effective in reducing IOP in those patients with pressures considered high or uncontrolled.

ABiC Webinar: A New MIGS on the Block?
AAO 2016
Mahmoud A. Khaimi, MD
Dean McGee Eye Institute, USA

In this webinar, Dr. Mahmoud A. Khaimi addresses his 12-month data for ABiC, both as as a stand-alone procedure, and as an adjunct procedure performed in conjunction with cataract surgery. On average, in cases where ABiC was performed outside cataract surgery, IOP was reduced from a baseline of 21.96 mmHg to 16.00 mmHg at 12 months. When performed in conjunction with cataract surgery, ABiC reduced IOP from a mean baseline of 17.80 mm Hg to 14.82 mm Hg at 12 months. Importantly, ABiC was shown to be effective in both phakic and pseudophakic patients.

ABiC Webinar: A New MIGS on the Block?
ESCRS 2016 (Video 1 of 4)
Noerbert Koerber, FEBO (Germany)

A pioneer of Canaloplasty, Prof. Koerber of Augencentrum Koeln, Germany, and the University Eye Hospital, Padova, Italy, spotlights the evolving roles of ABiC and Canaloplasty.

ABiC Webinar: A New MIGS on the Block?
ESCRS 2016 (Video 2 of 4)
Mahmoud A. Khaimi, MD (USA)

Glaucoma surgeon and pioneer of ABiC, Dr. Khaimi, Dean McGee Eye Institute, University of Oklahoma, addresses the treatment paradigm for glaucoma and how the advent of MIGS – specifically ABiC (ab–interno Canaloplasty) – has transformed the treatment of his glaucoma patients.

ABiC Webinar: A New MIGS on the Block?
ESCRS 2016 (Video 3 of 4)
Mark J. Gallardo, MD (USA)

MIGS expert Dr. Gallardo, El Paso Eye Surgeons, Texas, addresses the role of ABiC in clinical practice in cases of both controlled and uncontrolled glaucoma.

ABiC Webinar: A New MIGS on the Block?
ESCRS 2016 (Video 4 of 4)
Q & A Session

Informative Q&A session addressing a number of topics, including:

  • Is ABiC equally effective in cases of pigmentary glaucoma?
  • It is unclear why Schlemm’s Canal closes in the first place? Do you expect it to again close in post-ABiC patients in five or so years from now?
  • Can ABiC be repeated?
  • What instrument do you use to feed into Schlemm’s Canal?
  • Does the use of Healon in Schlemm’s Canal cause an initial IOP spike?
  • Is there a risk of bursting into the anterior chamber when delivering 15-20 clicks of viscoelastic?

ABiC Clinical Footage

ABiC: Restoring the Natural Pathway
Mahmoud A. Khaimi, MD
Dean McGee Eye Institute, USA

One of the challenges associated with the use of stent-based MIGS is that the location of increased aqueous outflow resistance is often unclear: when targeting a small area of the outflow system only there is a risk that the area of blockage will be missed or sub optimally treated. A comprehensive MIGS procedure, ABiC™ accesses, catheterizes, and viscodilates the trabecular meshwork, Schlemm’s canal, and importantly, the distal outflow system, beginning with the collector channels – thus addressing all aspects of potential outflow resistance.

ABiC: Clinical Footage
Mark J. Gallardo, MD
EL Paso Eye Surgeons, USA

Unedited video of ABiC in a phakic patient with primary open-angle glaucoma. During the procedure, Goniotomy, 360° cannulation and visco-dilation of Schlemm’s canal with the iTrack microcatheter are performed. Once the distal end has circumnavigated to the point of entry the iTrack is slowly withdrawn, while Healon/Healon GV is emitted upon single clicks of the visco-injector knob.

ABiC: A Comprenhensive Approach to MIGS
Mark J. Gallardo
El Paso Eye Surgeons, PA, USA

Ab-interno Canaloplasty is a new MIGS procedure, which achieves similar IOP-lowering effects to traditional (ab-externo) Canaloplasty in patients with mild-to-moderate POAG. During the ab-interno Canaloplasty procedure, Goniotomy, 360° cannulation and visco-dilation of Schlemm’s canal with the iTrackTM microcatheter are performed. Once the distal end has circumnavigated to the point of entry the iTrackTM is slowly withdrawn, while Healon/Healon GV is emitted upon single clicks of the visco-injector knob.

ABiC: According to the Expert
Mark J. Gallardo, MD
EL Paso Eye Surgeons, USA

According to ABiC expert Mark J. Gallardo, MD, to become a successful ABiC surgeon, one must properly ensure good visualization of the nasal drainage angle. The temporal clear corneal wound should be made directly across from the nasal angle, and side port incisions should be 90º from this angle. Corneal incisions should avoid the limbal vessels as much as possible, as surface bleeding can stain the viscoelastic used as a coupling agent for the gonioscopy lens and hinder the view to the drainage angle. Watch this instructional video to learn more.

ABiC: Clinical Footage (Stand-Alone Procedure)
Mahmoud A. Khaimi, MD
Dean McGee Eye Institute, USA

According to Dr. Khaimi, ABiC can be performed in three easy steps.
“First, I perform a clear temporal incision approximately 1.8 mm-wide. I then inject an OVD into the anterior chamber in order to maintain stability. Next, I place the iTrack microcatheter into anterior chamber in preparation for insertion into Schlemm’s canal. I then use a 27-gauge needle and perform a small goniotomy, before placing the iTrack into Schlemm’s canal and advancing it 360-degrees. I then pull the iTrack out and viscodilate. I typically get 15-20 clicks. It is important to note that this is a fair bit more viscodilation than with traditional Canaloplasty, made possible by the fact that we first use an OVD to maintain stability.”