SIGS MMC超声乳化

SIGS or Stab Incision glaucoma Surgery is a technique for guarded filtration surgery described by me in the beginning of 2013. As of March 2015, there are more than 250 cases performed by the Dr. Agarwal's Eye Hospital group in India and more than 120 performed by the group in Africa. It has also been adopted by various doctors in USA, Europe, Asia and the Middle East.
This video shows Step by Step the technique for performing a SIGS with latest modifications. It would be useful for someone starting out with SIGS to view it.
Pre-op MMC: 0.2 ml of 0.02% in the sub-conjunctival space about 6 mm from the limbus 20 minutes prior to surgery and then start surgery. This prevents the conjunctival lips from scarring down. This is easy and safe and avoids need for conj incision to be opened excessively and is what i do in all cases now. Many prominent glaucoma surgeons use the pre-op sub-conj injection of MMC in their trabeculectomy cases as well and this is an accepted technique. Pre op MMC is given tangential to limbus 6mm above the superior limbus. So it is above the site of the incision. Also you are introducing the needle from temporal conjunctiva and going parallel to limbus till you reach your site of intended surgery and then inject. So no buttonhole occurs at the site of bleb.

                               
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