HFDS^® for modern MIGS surgery

For surgical treatment of glaucoma, the OS 4 generates appreciable added value in microinvasive glaucoma surgery (MIGS). High‑Frequency Deep Sclerotomy (HFDS) has a low rate of complications and delivers promising long-term results even with a shorter procedure. 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 provide an improved outflow of the aqueous humour.

How does HFDS work?

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

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]}.

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

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?

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 OS 4 ensures exceptional results thanks to its cleverly thought-out fluidics concept andinnovative 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}

HFDS^® for modern MIGS surgery