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 detail
8. 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.
See HFDS® in application now
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
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MAKING THE DIFFERENCE WITH UNIQUE ADVANTAGES
«HFDS offers three unique advantages in glaucoma surgery.
First, in about 70% of cases no postoperative treatment with medication is required. The second and biggest advantage in my opinion is that trabeculotomy and trabeculoplasty can be replaced by HFDS. Third, HFDS and phaco act additively and thus an IOP reduction of up to 13 mmHg can be achieved D.»Dr. Gonzalo Murillo AzcarragaInstituto Privado de Oftalmología La Paz, Bolivia -
MAKING THE DIFFERENCE WITH A MODERN GLAUCOMA METHOD
«Thanks to the modern HFDS method from Oertli, I am able to work quick and safe with little effort. It is also a good alternative to implants or filter surgery. The result speaks for itself - many patients are well regulated even after months without glaucoma drops D.»
PD Dr. med. Hans-Joachim HettlichAugen Praxisklinik Minden, Germany -
MAKING THE DIFFERENCE WITH EXCELLENT LONG-TERM RESULTS
«HFDS convinces me because the procedure is very easy to perform, highly controllable and with few complications. Thanks to HFDS, excellent long-term results are achieved, resulting in fewer follow-up treatments for patients D.»
Dr. med., F.E.B.O. Lutz BlombergAugenzentrum Hildesheim-Alfeld, Germany -
MAKING THE DIFFERENCE IN GLAUCOMA SURGERY
«For me, HFDS is an easy to apply MIGS solution, which convinces not only because of the fast rehabilitation post-op. High frequency diathermy is used to reduce the outflow resistance and shows excellent eye pressure reduction. HFDS can be excellently combined with cataract surgery D.»
Prof. Bojan PajicEye Clinic Orasis, Reinach, Switzerland
HFDS in glaucoma surgery
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