HFDS® for modern MIGS surgery

The Faros provides an option for surgical treatment of glaucoma in micro‑invasive glaucoma surgery (MIGS). High-Frequency Deep Sclerotomy (HFDS) creates a direct access between the anterior chamber and the Schlemm canal that bypasses the outflow resistance of the trabecular meshwork. The HFDS glaucoma tip is inserted through a 1.2‑mm paracentesis and six small sclerotomy pockets are formed in the iridocorneal angle to improve the outflow of the aqueous fluid.

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How does HFDS work?

Graphic Moisten of the cornea

1. Anaesthesia & moisten of the cornea

Graphic incision

2. Incision

Make a 1.2 mm incision temporal or temporal superior for a nasal approach.

Graphic Miosis

3. Miosis

To constrict the pupil, inject a miotic preparation.

Graphic Position the anterior chamber

4. Position the anterior chamber

Fill the anterior chamber with high viscosity OVD.

Graphic Visualisation of the iridocorneal angle

5. Visualisation

Use a direct or indirect gonioscope for optimal viewing of the iridocorneal angle and the trabecular meshwork.

Graphic Positioning in the iridocorneal angle

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.

Graphic HFDS procedure

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
Graphic Postoperative medication

8. Postoperative medication

More about the postoperative medication

REDUCTION OF THE IOP

Clinical studies confirm a long-term significant reduction in the IOP with a considerable reduction in the number of antiglaucoma medication (AGM)[2]. Together with the low complication rates, HFDS is a safe and efficient glaucoma procedure[2, 8, 14].

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Advantages of HFDS®

  • Implant‑free micro‑invasive glaucoma surgery[20]
  • Impressive long-term results with a stable and
    long-term reduction in IOP and AGM[2]
  • Short procedure time with high safety profile[2, 8, 14]
  • Combined with cataract surgery or a stand-alone
    application
Image application HFDS glaucoma tip

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

You want to know more?

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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.»

    Dr. Gonzalo Murillo Azcarraga
    Instituto Privado de Oftalmología La Paz, Bolivia
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    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.»

    PD Dr. med. Hans-Joachim Hettlich
    Augen Praxisklinik Minden, Germany
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    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.»

    Dr. med., F.E.B.O. Lutz Blomberg
    Augenzentrum Hildesheim-Alfeld, Germany
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    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.»

    Prof. Bojan Pajic
    Eye Clinic Orasis, Reinach, Switzerland

HFDS in glaucoma surgery

Learn more about about the instruments for glaucoma surgery.

More about HFDS

The HFDS DryLab KIT

With the compact, mobile and flexible training tool, we provide a more impactful introduction into HFDS than ever before.

More about the HFDS DryLab KIT

Cataract surgery

Innovations such as HF capsulotomy and easyPhaco are developments that aim to make cataract surgery faster and more efficient.

More about cataract

Vitreoretinal surgery

In vitrectomy surgery, the Faros ensures exceptional results thanks to its cleverly thought-out fluidics concept and innovative instruments.

More about vitrectomy

Oertli data on file

[2] B. Pajic, B. Pajic-Eggspuehler, and I. Haefliger, “New minimally invasive, deep sclerotomy ab-interno surgical procedure for glaucoma, six years of follow-up,” Journal of glaucoma, vol. 20, no. 2, pp. 109–114, 2011, doi: 10.1097/IJG.0b013e3181dddf31.

[8] B. Pajic, Z. Cvejic, K. Mansouri, M. Resan, and R. Allemann, “High-Frequency Deep Sclerotomy, A Minimal Invasive Ab-interno Glaucoma Procedure Combined with Cataract Surgery: Physical Properties and Clinical Outcome,” Applied Sciences, vol. 10, no. 1, p. 218, 2020, doi: 10.3390/app10010218.

[14] Kaweh Mansouri, M.D., M.P.H., A Multicenter Prospective Study of High-Frequency Deep Sclerotomy (HFDS) in Open-Angle Glaucoma: 3-Year Outcomes: Manuskript; UNPUBLISHED DATA.

[20] Aleksandar Pavlovic, Ab-Interno Deep Sclerotomy in Eight Simple Steps. [Online]. Available: https://www.oertli-instruments.com/downloads/glaukom/crst_september_2017_ab-interno_deep_sclerotomy_in_eight_simple_steps.pdf

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