1483 – Micro-bypass stenting for open-angle glaucoma (in trabecular meshwork)

New MBS item.

A trabecular micro-bypass stent is a micro-invasive glaucoma surgery (MIGS) device used to treat patients with mild-to-moderate primary open-angle glaucoma (POAG), a previously unaddressed population in POAG surgical treatment. The device improves aqueous outflow through the natural physiologic pathway, the trabecular meshwork, thereby lowering intra-ocular pressure (IOP) and dependence on pressure-lowering topical medication. The procedure is generally performed as a day-stay procedure in an ophthalmology surgical setting, as a stand-alone treatment or in conjunction with cataract surgery.

Type: Therapeutic

Glaucoma is a chronic degenerative optic neuropathy in which the neuro-retinal rim of the optic nerve becomes progressively thinner, caused by an acquired loss of retinal ganglion cell axons and atrophy of the optic nerve. The lens and cornea of the eye both lack direct blood supply. Therefore, these anterior structures are nourished by a separate circulatory system. The aqueous humor, produced by the ciliary body, circulates throughout the anterior chamber and drains through the trabecular meshwork in the iridocorneal angle. Its primary role is to maintain intraocular pressure (IOP), and provide nutrients to the structures of the anterior and posterior chambers of the eye.

In open-angle glaucoma (OAG), the iridocorneal angle is unobstructed but aqueous outflow is diminished, leading to an elevation of intraocular pressure. Patients with glaucoma typically lose peripheral vision, and may suffer complete vison loss if not treated.

• PASC meeting: 12 April 2017
• ESC meeting: 5 October 2017
• MSAC meeting: 23 November 2017