1496 – Micro-bypass stenting for open-angle glaucoma (external to Schlemm's canal)

New MBS item.

Micro-Stent implantation involves a minimally invasive glaucoma surgery (MIGS) device, and is a ab interno, bleb-less, conjunctiva-sparing procedure. The device improves aqueous outflow through the natural physiologic uveoscleral outflow pathway, thereby lowering IOP and dependence on pressure-lowering topical medication. The procedure is generally performed as a day surgery procedure in an ophthalmology surgical setting, in conjunction with cataract surgery or as a stand-alone treatment.

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 humour, produced by the ciliary body, circulates throughout the anterior chamber and drains through the uveoscleral outflow 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 aqueous outflow is diminished, leading to an elevation of IOP. Patients with glaucoma typically lose peripheral vision, and may suffer complete vision loss if not treated.

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