Clinical Report: Enhancing Uveoscleral Outflow Post-MIGS with AlloFlo Uveo

Overview

AlloFlo Uveo offers a novel, bleb-free surgical option to enhance uveoscleral outflow in glaucoma patients with prior MIGS, demonstrating significant and durable intraocular pressure (IOP) reduction and medication burden decrease. Early clinical experiences highlight its safety, ease of use, and potential to delay or avoid filtering surgery.

Background

Minimally invasive glaucoma surgeries (MIGS) primarily target trabecular outflow but often lose efficacy over time, leading to increased medication use and consideration of bleb-forming procedures. The uveoscleral pathway, a natural alternative outflow route, has traditionally been accessible only via medications. AlloFlo Uveo is a new bio-interventional device designed to enhance this pathway surgically without conjunctival manipulation or bleb formation. This approach aims to extend the benefits of angle surgery and provide an intermediate treatment option before filtering surgery.

Data Highlights

Key Findings

• AlloFlo Uveo procedure is quick (5-10 minutes) and minimally traumatic due to soft, flexible scleral tissue.
• Patients with prior MIGS and rising IOP benefit from targeting the uveoscleral outflow pathway.
• Significant and sustained IOP reductions observed up to one year post-procedure.
• Medication burden decreased in most patients, with some becoming drop-free.
• The procedure has a short learning curve, with surgeons comfortable after 3-5 cases.
• AlloFlo Uveo fills a treatment gap between trabecular MIGS and filtering surgery, preserving conjunctival integrity.

Clinical Implications

AlloFlo Uveo provides clinicians with a valuable intermediate surgical option for glaucoma patients experiencing waning MIGS efficacy, especially pseudophakic patients on multiple medications. By enhancing the uveoscleral outflow pathway without conjunctival disruption, it may delay or obviate the need for more invasive filtering surgeries. Early adoption can improve patient outcomes by maintaining physiologic outflow and reducing medication dependence.

Conclusion

AlloFlo Uveo represents a promising advancement in glaucoma surgery by unlocking the uveoscleral outflow pathway, offering durable IOP control and medication reduction in post-MIGS patients. This approach broadens the surgical armamentarium, enabling more comprehensive and physiologic glaucoma management.

References

1. Pan B, Desai P 2024 -- Unlocking Uveoscleral Outflow: A New Path Awaits Post-MIGS