3.5 years ago

Pgw • 10

@pgw

Does anyone have experience with Omni 360 System? I was diagnosed with iop 1 year ago and cannot find a drop I can tolerate for more than a couple of months due to horrible headaches,palpitations the list is long. I'm a very healthy 67 yr old and take no meds except a vitamin d occasionally. Am going to try nanodropper and pipettes. Appreciate any advice.

3.5 years ago

david 4.3k

@david_fe

According to the study cited below, there is a good chance the Omni 360 would allow you to get off of eye drops. (However, rather than picking a specific MIGS technique, maybe you should pick a glaucoma specialist you trust and get their advice on the best MIGS procedure for you.)

Visco 360/OMNI

Device Design

The VISCO360 system injects a predetermined amount of viscoelastic fluid into Schlemm’s canal (and the distal collector channels).  The procedure covers the full 360 degrees of the eye (surgically done in two halves). The procedure allows for dilation without tissue destruction of the natural drainage system. 

Indication

The Visco 360/OMNI System can be performed as a stand-alone procedure or in combination with cataract surgery. 

Clinical Outcomes

A study by Ondrejka and Korber evaluated the effectiveness of the VISCO360 viscosurgical system for the treatment of mild to moderate primary open angle glaucoma.[[20]] 

Of the 72 eyes in group ONE, 11 underwent VISCO360 alone and 61 underwent VISCO360 with cataract extraction.  At 12 months post-operatively, there was a significant reduction in IOP from a baseline of 24.6±7.1 mmHg to 14.6±2.8 mmHg with an average reduction in IOP of 41% across all eyes. 

Additionally, 87% of eyes in group 1 achieved ≥20% reduction in IOP from baseline.  There was also a significant reduction in IOP lowering drops in group 1 eyes from 2.1±1 to 0.2±0.6 and 85% of eyes required no medications to maintain pre-operative IOP or lower. 

Of the 34 eyes in group TWO, 33 underwent VISCO360 with cataract extraction and only 1 underwent stand-alone VISCO360. There was a significant reduction in medications at 12 months from 1.8±0.9 to 0.2±0.6 post-operatively.  Further, 88% of eyes in groups 2 were off all IOP lowering drops at 12 months with IOP at baseline.

In both groups, there was an excellent safety profile with only 14 eyes experiencing a hyphema, most of which were sub-millimeter in size.  There were no subsequent surgical interventions related to the VISCO360. 

Microinvasive Glaucoma Surgery (MIGS) - EyeWiki#Visco_360.2FOMNI)

3.5 years ago

Mary Beth • 350

@beth

Yes, find a superb surgeon whom you trust first. Ask success rate and how many times they have done a recommended procedure. Then dare to ask what is plan for post-surgical IOP spike because of adverse reaction to standard post-op steroids, common in glaucoma eyes. Then, the double dare—ask what the back up plan for a scenario where the proposed surgery performs poorly.

After I had been through a very long list of annoying and some threatening side effects, my doctor did SLT, back in time when it was the new alternative to the damaging ALT. It has since twice been repeated in each eye (it works for years) and there is definitely some surgeon skill involved. It takes about 10 minutes in the office, topical numbing eye drop only. NSAID topical drop afterwards for a few days too. Find a surgeon who has successes with this procedure. Insurance pays, especially when documented chain of drug failure to tolerate instances.

I am currently investigating the also repeatable MP3 micro pulse laser. It is a bit more involved. Those skilled in its use do get fantastic results, and it has been being used in early treatment.

Yes, MIGS are effective, but I read a lot about 1 being insufficient. That’s probably why Omni 360 was appealing to you.