Microstent Trimmers Launched to Trim Stent Protrusions

■ Two companies, Epsilon Instruments and MicroSurgical Technology (MST), have collaborated with glaucoma surgeons to develop and launch microstent trimmers to cut protruding sections of a malpositioned Cypass microstent (Alcon) in a minimally invasive fashion. Epsilon Instruments has launched the Grover-Emanuel-Fellman Cypass Trimmers in collaboration with Davinder Grover, MD, Matthew E. Emanuel, MD, and Ronald L. Fellman, MD. MST, in collaboration with glaucoma surgeon Ike Ahmed, MD, has developed the MST 19-gauge Ahmed Micro Stent Cutter.

Following the 2018 recall of the Cypass microstent, a task force of the American Society of Cataract and Refractive Surgery developed a consensus statement to guide care for patients who had received the stent. The statement suggested that patients should be monitored for evidence of endothelial cell loss. If the patient and physician desire intervention, trimming of the proximal end is likely to be the preferred procedure.

Both microstent trimmers are designed to be used with one hand. “I tried several scissors ... but they all required 2 hands, leaving no option to hold the gonioprism,” said Dr. Ahmed in a news release, adding that the scissors also did not cut the stent well. Trimming the implant would require a unique instrument for access and cutting effectiveness, “similar to a cigar cutter in some ways,” added Dr. Ahmed.

“The design allows for coaxial access to the stent protrusion for trimming. The cutting action of the forceps provides a clean and close cut, that retains the remnant for easy removal. The multifunctional instrument enables the procedure to be fast and effective with little to no adverse effects or need for multiple instruments,” Dave Scott, MST’s vice president of new product development, said of the Ahmed cutter in the news release.

A portion of the sales of the Grover-Emanuel-Fellman Cypass Trimmers will be donated to the Cure Glaucoma Foundation.