Around this time 2 years ago, I was fortunate to visit Florence for the 13th Congress of the European Glaucoma Society (EGS). What a beautiful city with a history to match. Above is a picture I took of the Ponte Vecchio at night.
Whilst at the Congress, I recall attending a symposium on the Cypass, a drainage device intended to help treat glaucoma by increasing outflow via the uveoscleral pathway. It was a minimally invasive glaucoma surgery (MIGS) device that was approved in 2016 and was being promoted at the time of the Congress in 2018. The ophthalmic company, Alcon, had paid a significant sum to purchase the rights to market the device.
Personally, I like to see how new treatments perform before taking them up in my practice and as the Cypass had been available for 2+ years, I attended the symposium to see if it would work for my patients.
The data presented on the Cypass at the European Glaucoma Society seemed convincing and I was debating whether to undergo the relevant training to start implanting the device in patients.
However, soon after the congress, further clinical data became available showing that patients who had the Cypass device implanted developed corneal endothelial cell loss and the device was withdrawn.
Why do I write about this now?
It is because I was reminded by Google of the photos I took on that trip including the panorama of Florence below. I wish I was on holiday somewhere like Florence but alas COVID has other plans for us at the moment. I hope that by looking at these pictures and remembering that there is life outside COVID, it will lift all our spirits.
I also wanted to share how medical care develops and the challenges that arise as we each grow through our practice. It is not simple, plain sailing to be a clinician and there are often events that make you reflect.
My reflections around this episode have been as follows
What would I do had I implanted this device in my patients between 2016 – 2018?
How long should we wait before adopting new treatment paradigms?
I am also reminded of this quote by Al-Razi (Rhazes).
“Truth in medicine is an unattainable goal and the art as described in books is far beneath the knowledge of an experienced and thoughtful clinician.”Al Razi
My current go to MIGS procedure is iStent inject combined with cataract surgery. I have been implanting iStents since around 2010 and pioneered the implantation of these stents in Birmingham. We have been getting good results and have now built up a long track record of these interventions and their outcomes. Please click the link to one such case.
#Cypass, #iStentinject, #Florence, #Rhazes #MIGS, #Glaucoma