Abstract:

The Beacon Aqueous Microshunt (BAM) is an investigational, ab externo, Minimally Invasive Glaucoma Surgery (MIGS) implant manufactured by MicroOptx (Maple Grove, MN). The implant is inserted superiorly at the limbus to direct outflow of aqueous humor (AH) from the anterior chamber to the tear film, with the intent of reducing intraocular pressure (IOP). The implant utilizes a polyethylene glycol (PEG) hydrogel channel to shunt AH. The diameter of the channel is engineered to specific calculations to provide controlled-outflow resistance of AH for optimal IOP reduction. The PEG hydrogel material is considered the gold standard for anti-biofouling polymers, preventing protein adsorption and bacterial attachment. The BAM is currently in pre-market clinical investigations in US and Europe.
We treated the left eye of a 48-year-old male with refractory glaucoma. Medical history included POAG OU for 10 years and inactive pigmentary glaucoma OS on Pilocarpine OU, Vyzulta OU, Ripasudil OU, Combigan OU. Surgical history included Canaloplasty converted to Trabeculectomy OD; SLT OU X2; Laser PI OD; Micropulse CPC OU X3. Patient consented to the implant procedure, and the BAM was implanted at 12 o’clock position without complications. Flow through the channel was confirmed by Seidel’s test. Preop IOP (medicated) was lowered from 33 mmHg to 12mmHg without medications at both 3- and 6-months postop. Tear film, measured by Schirmer’s Tear Test, increased from 17 mm/5min at baseline to 35 mm/5 min and 26 mm/5 min at 3- and 6-months, respectively. No complications have occurred. Potential risks include device blockage, infection, possible foreign body sensation, and hypotony. Benefits of BAM include no bleb; ease of implantation and device removal (if needed); ease at assessing channel functionality by Seidel’s Test; and stand-alone procedure. of surgery for glaucoma. In our patient with refractory glaucoma, BAM safely provided significant IOP reduction, discontinuation of medication, and increased tear film.