Objective:

To explore innovative drainage strategies targeting the supraciliary space for managing elevated intraocular pressure (IOP) in glaucoma patients, emphasizing the critical role of IOP management in preventing glaucoma progression.

Key Findings:

• Supraciliary MIGS devices can effectively lower IOP with fewer complications compared to traditional surgeries, highlighting their potential role in clinical practice.
• The CyPass microstent showed significant endothelial cell loss, leading to its withdrawal from the market, raising safety concerns.
• The MINIject demonstrated a significant reduction in IOP in patients with medically uncontrolled primary open-angle glaucoma, indicating its promise as a treatment option.

Interpretation:

Targeting the supraciliary space represents a promising alternative to traditional glaucoma surgeries, potentially offering effective IOP management with reduced complication rates, though risks must be carefully considered.

Limitations:

• The long-term safety and efficacy of newer devices like the MINIject are still under investigation, necessitating caution in clinical application.
• The CyPass microstent's withdrawal raises concerns about the safety of supraciliary approaches, underscoring the need for thorough evaluation of new devices.

Conclusion:

Innovative approaches to accessing the supraciliary space may enhance glaucoma treatment options, but further research is needed to establish their long-term safety and effectiveness, reinforcing the importance of ongoing clinical trials.