Trabecular microbypass refers to minimally invasive glaucoma surgery (MIGS) that places tiny stents through the trabecular meshwork into Schlemm’s canal. These devices create a direct channel for aqueous humour to bypass resistance and lower intraocular pressure.
Procedure
Through a small corneal incision, the surgeon uses a goniolens to visualise the drainage angle and insert one or more microstents. The operation is often combined with cataract surgery.
- Examples include various trabecular bypass stent systems
- Intended for mild to moderate open‑angle glaucoma
- Recovery is usually quick with minimal discomfort
- Pressure reduction is modest compared with traditional filtering surgery but with a higher safety profile
Advantages and Limitations
Trabecular microbypass can reduce drop burden and delay or avoid more invasive operations. However, it may not achieve sufficiently low pressures in advanced disease.
- Pre-existing angle damage or synechiae may limit suitability
- Gonioscopic skills are essential for accurate placement
- Devices can malfunction or become obstructed, though serious complications are uncommon
- Ongoing glaucoma monitoring remains necessary
