EDITORIAL

Abstract

Dear friends, Innovations and updation is the heart and soul of ophthalmology. As we move towards reducing the incision size, we also aim for being sutureless. Traditional glaucoma surgery requires placement of several sutures and so has its associated disadvantage too. Now the trend is sutureless glaucoma surgery and that’s where comes the expanding role of various MIGS (Micro incision / Micro Invasive Glaucoma surgery) procedures. The MIGS procedures can be Ab interno or Ab externo that are primarily divided into four types based on the site of enhancing aqueous humor drainage or reducing inflow are following1: 1. Increasing outflow across the trabecular meshwork and through Schlemm’s canal2,3,4 2. Enhancing uveo-scleral outflow through supra-choroidal space3 3. Shunting aqueous into the sub-conjunctival space5 4. Decreasing aqueous production by ablation of the ciliary processes6 The results are promising in properly selected patients. The various advantages are improved safety and subsequent reduced risk of complications like choroidal detachment, hypotony, hemorrhage, and effusion.1 Moreover, there is physiological aqueous outflow by minimal disruption to angle structures. Good post-operative recovery with minimal bedtime for patients is also an important factor while offering MIGS as an option to the indicated patients. Although, MIGS is coming up as an excellent alternative to traditional angle surgery in lowering the IOP but the amount of IOP reduction is lesser than trabeculectomy and is reported to be at least 20%-30%.2-6 But even that is good as it shall control IOP in mild/moderate glaucoma thus eliminating or reducing the requirement of daily medications. There are certain contraindications to the procedure like angle closure glaucoma, inflammatory glaucoma/uveitic glaucoma, neovascular glaucoma, glaucoma with angle dysgenesis etc where angle visualization is poor or not possible.1 Moreover, it has a learning curve and so shall be attempted only after proper understanding of the anatomy of angle structures and training. Happy to bring before you another issue of UP Journal of Ophthalmology. We have wonderful guest editorial from very renowned vitreoretinal surgeon of international repute, Dr S. Natarajan Sir. There are other interesting articles to quench your thirst for the knowledge, I thank to all the contributors for their excellent write ups. My sincere thanks to President UPSOS Dr OPS Maurya, Secretary Dr Mohita Sharma, Joint Editor Dr Divya Kesarwani for their support along with whole editorial team and executive body. Till then happy reading. Warm Regards Shalini Mohan, MBBS (Gold Medalist), MS, DNB, MNAMS Editor in Chief Professor of Ophthalmololgy, Officer Incharge: Glaucoma & Cornea GSVM Medical College, Kanpur President: Kanpur Ophthalmic Society