HFDS® for modern MIGS surgery
In the treatment of glaucoma, the HFDS ab interno MIGS procedure from Oertli delivers promising long-term results 2. High-Frequency Deep Sclerotomy (HFDS) provides direct access from the anterior chamber to the Schlemm's canal and further into the sclera. The outflow resistance of the trabecular meshwork is thus significantly reduced. The HFDS glaucoma tip is inserted through a 1.2‑mm paracentesis and uses high-frequency diathermy delivery to place six small sclerotomy pockets in the iridocorneal angle, which provides an improved outflow of the aqueous humour. HFDS results in a low complication rate and promising long-term outcomes in spite of the short intervention time 3, 4, 5
How does HFDS work in glaucoma surgery?
1. Anaesthesia & moisten of the cornea
2. Incision
Make a 1.2 mm incision temporal or temporal superior for a nasal approach.
3. Miosis
To constrict the pupil, inject a miotic preparation.
4. Position the anterior chamber
Fill the anterior chamber with high viscosity OVD.
5. Visualisation
Use a direct or indirect gonioscope for optimal viewing of the iridocorneal angle and the trabecular meshwork.
6. Positioning
Insert the HFDS glaucoma tip through the incision/paracentesis into the anterior chamber and position the tip below Schwalbe's line and above the scleral spur in order to penetrate the trabecular meshwork.
7. HFDS procedure
By simulatively pressing the foot pedal, six new 1 mm deep pockets are created. Finally, a BSS/viscoelastic exchange is performed.
The HFDS procedure in detail8. Postoperative medication
More about the postoperative medicationREDUCTION OF THE IOP
Clinical studies confirm a long-term reduction in the IOP and the number of antiglaucoma medication (AGM) 2.
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What do experts say about HFDS®?
Dr Florian Sutter
Eye clinic Herisau and Appenzell, Switzerland
Lenght: 10 min
Dr Robert Kromer
nordBlick Eye clinic Bellevue Kiel, Germany
Length: 11 min
Do you want to know more?
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High Frequency Deep Sclerotomy, Dr Florian Sutter, Ophthalmology Times Europe, 2022
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Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery, Journal of Clinical Medicine, 2021
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Ab Interno Approach with No Implant Needed, The Ophthalmologist, 2021
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High-Frequency Deep Sclerotomy, A Minimal Invasive Ab Interno Glaucoma Procedure Combined with Cataract Surgery: Physical Properties and Clinical Outcome, Eye Clinic Orasis, 2019
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The Efficacy and Safety of High-Frequency Deep Sclerotomy in Treatment of Chronic Open-Angle Glaucoma Patients, Research Institute of Ophthalmology Cairo, Cairo University Faculty of Medicine, 2019
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Ab-Interno Deep Sclerotomy in Eight Simple Steps, Cataract & Refractive Surgery Today Europe, 2017
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The Future Way of Phaco & MIGS Surgeries - Highlights from ESCRS Satellite Symposium, The Ophthalmologist, 2015
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HFDS Glaucoma Procedure, Dr. Bojan Pajic, European Opthalmic Review, 2012
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New Minimally Invasive, Deep Sclerotomy ab interno Surgical Procedure for Glaucoma, Six Years of Follow-up, Dr. Bojan Pajic, Journal of Glaucoma, 2011
HFDS in glaucoma surgery
Learn more about about the instruments for glaucoma surgery.
The HFDS DryLab KIT
With the compact, mobile and flexible training tool, we provide a more impactful introduction into HFDS than ever before.
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