SEPTEMBER 2017: Following consultation and the availability of further evidence, this topic has been referred back the Interventional Procedures Advisory Committee for further consideration. A further consultation document will be issued in due course.
 
Status In progress
Process IP
ID number 1523
Description Microinvasive insertion of a trans-scleral gelatin stent via the ab interno (anterior chamber) approach for treating open-angle glaucoma is a minimally invasive procedure. It involves implanting a gelatin stent, a collagen-derived drainage device, to reduce intraocular pressure. The procedure creates an artificial bypass channel and drainage pathway from the anterior chamber into the non-dissected tissue of the subconjunctival space to improve drainage and outflow of aqueous humor. This procedure can be done at the same time as phacoemulsification and intraocular lens insertion for treating cataracts. Under local or topical anaesthesia, a small incision is made in the cornea, and the anterior chamber is filled with viscoelastic. A preloaded implant injector is then advanced through the same corneal incision and directed towards the scleral spur. The injector needle is directed through the sclera to emerge under the conjunctiva, approximately 2 mm to 3 mm behind the limbus. The soft and permanent gelatin stent is then injected, to traverse the anterior chamber, sclera and conjunctival space. After placement is checked (using a gonioscopy mirror) the viscoelastic is exchanged for a balanced salt solution and the injector is withdrawn. The corneal incision is usually self-sealing but is sometimes sutured. Subconjunctival injection of mitomycin-C may be done during the procedure.

Timeline

Key events during the development of the guidance:

Date Update
26 July 2017 - 23 August 2017 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance