Bio-Interventional Glaucoma Surgery
In Redwood City and the Bay Area
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A newer glaucoma surgery that uses natural tissue, not a synthetic implant, to open and support the eye’s second drainage pathway.
What is bio-interventional glaucoma surgery?
Bio-interventional glaucoma surgery is one of the newest ways to lower eye pressure. Instead of placing a permanent synthetic stent, the surgeon uses a small piece of natural, sterile donor tissue to open and support a drainage pathway inside the eye. It is part of an interventional approach to glaucoma, which treats the disease earlier with procedures instead of only adding more eye drops.
Dr. Philip Ngai is a fellowship trained glaucoma specialist who performs bio-interventional surgery, including AlloFlo, and teaches the technique to other eye surgeons. Learn more on our glaucoma care and interventional glaucoma pages.
How it works
Your eye has two natural drains. Most MIGS procedures improve the main drain in the angle of the eye. Bio-interventional surgery works on the second drain, called the uveoscleral pathway, which lets fluid leave through the tissues behind the colored part of the eye.
- Through a tiny incision, Dr. Ngai gently opens a small channel into the uveoscleral pathway.
- A thin strip of sterile donor scleral tissue is placed to keep the channel open.
- The tissue is soft and flexible, so it conforms to the eye, and the eye’s main drain is left untouched for future options.
- It can be done on its own or at the same time as cataract surgery.
Who may benefit?
- Open angle glaucoma that needs more pressure lowering
- Glaucoma that is not controlled well enough with drops, laser or MIGS
- Patients who want to reduce their daily eye drops
- Patients who may be able to delay or avoid bleb or tube surgery
- Patients having cataract surgery who also need better pressure control
It is not the right choice for every type of glaucoma, such as some forms of inflammatory or neovascular glaucoma. Dr. Ngai reviews your exam and testing to recommend the best option for your eyes.
What to expect
Bio-interventional surgery is an outpatient procedure at a nearby surgery center, usually with light sedation and numbing. Most patients return to light daily activities within a few days. You will use a special drop schedule for about three months and see us for follow up visits to check your pressure and healing.
Insurance coverage
Bio-interventional glaucoma surgery is a medical treatment for glaucoma. Our team checks your insurance coverage before surgery is scheduled. See surgery costs and insurance for more.
Benefits and risks
- Works on a different drainage pathway than most MIGS
- No permanent synthetic implant
- Small incision and a quick visual recovery for most patients
- Leaves future treatment options open
As with any eye surgery, risks include bleeding inside the eye, inflammation, eye pressure that is too high or too low, and the need for more treatment. Because this is a newer procedure, long term results are still being studied. Dr. Ngai will talk with you about the benefits and risks for your eyes.
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Related care to consider
Bio-interventional surgery FAQs
What does bio-interventional mean?
It means the procedure uses natural, biologic tissue instead of a synthetic device to support a new drainage path inside the eye.
Is bio-interventional surgery the same as MIGS?
It is closely related. Like MIGS, it uses a tiny incision and most patients recover quickly. Unlike most MIGS procedures, it works on the uveoscleral pathway, the eye’s second natural drain, instead of the main drain.
Where does the tissue come from?
It is sterile donor scleral tissue, the white outer coat of the eye, that has been screened and processed for safety by a tissue bank. Similar donor tissue has been used in eye surgery for many years.
Will I still need eye drops?
Many patients use fewer glaucoma drops after surgery, and some stop completely. It depends on how much your pressure drops and what your target pressure is. You will also use a temporary drop schedule while the eye heals.
Can it be combined with cataract surgery?
Yes. It can be done on its own or at the same time as cataract surgery, so both problems can be treated with one recovery.
Let’s take care of your eyes
Call, text or request an appointment online. We verify your insurance before your visit.
162 Clinton Street, Redwood City, CA 94062 ยท Monday to Friday, 8am to 5pm