ianTECH’s miLOOP saves time, improves comfort.

Conventional cataract surgery presents a variety of complexities for both the physician and the patient, including inflammation resulting from surgery and patient discomfort. In 2017, the FDA cleared ianTECH’s miLOOP — an energy-free, ophthalmic device — to help mitigate some of the intra- and postoperative challenges that frequently occur in cataract surgery.

HOW IT WORKS

The single-use device contains what its manufacturer describes as a “super-elastic, thin-filament” that results in full-thickness, endocapsular nuclear fragmentation by employing centripetal force. This feature distinguishes miLOOP from conventional devices, according to IanTech, which rely on centrifugal force to achieve fragmentation and require intra-operative aspiration and irrigation.

Also, the company says that the micro-interventional technology eliminates the need for large incisions while reducing operation time and decreasing the amount of energy introduced into the eye resulting from intraocular vibration. These two features increase patient comfort and shorten recovery time by decreasing cellular damage, according to two users.

One user, Michael Patterson, DO, of Eye Centers of Tennessee and the Debusk College of Osteopathic Medicine, says that, “Because the miLoop can go through a smaller incision, there is less risk for complications and inflammation and almost no stress on the zonules.”

SAVES ENERGY, CELLS AND TIME

Edward Holland, MD, director of Cornea Services at Cincinnati Eye Institute and professor of Ophthalmology at the University of Cincinnati, heard about the device via word-of-mouth and met with a local distributor to gather more information. Among the patients who can benefit from the miLoop, Dr. Holland recommends the device for patients with Fuchs’ dystrophy and patients who have harder lenses (3-4 NS), because miLoop reduces the amount of phaco energy and potential endothelial cell loss. Also, miLOOP may be useful in patients who have very soft lenses, as it can assist in nuclear segmentation.

Finally, patients with premium IOLs have high expectations for rapid visual recovery, and miLOOP can help by reducing phaco time.

Phacoemulsification, the gold standard of cataract surgery, has become increasingly important as comorbid glaucoma and cataracts continue to rise in prevalence.¹ However, phaco comes with some risks: The procedure uses ultrasound waves to break up the cataract. The duration of the procedure, combined with the significant amount of energy the procedure introduces into the eye, increases cell loss.

With its minimal energy introduction into the eye, the miLOOP offers an advantage over conventional phacoemulsification, says ianTECH.

However, the miLOOP is not typically used as a stand-alone device. ianTECH says it engineered the device for adjuvant use in conjunction with phacoemulsification to provide synergistic results, and ophthalmologists enjoy reduced stress associated with performing the operation along with more efficient procedures. “I didn’t realize it would make the overall procedure faster and more efficient,” says Dr. Holland. “In my first experience with the miLoop, I noticed the phacoemulsification times for hard lenses and the CDE were significantly lower. In addition, the cortex is much easier to remove in many cases.”

CONSIDERATIONS AND COSTS

Dr. Holland notes that some ophthalmologists may find initial training on the device a bit challenging; however, once trained, surgeons find operating the device relatively easy, with few complications.

“There’s not much of a learning curve with the miLOOP,” adds Dr. Patterson. “The most challenging aspect is that you have to trust the equipment because it lifts the lens a little bit and you have to make sure it doesn’t roll out of the bag.”

The miLOOP's price tag is approximately $150 per unit. However, as a single-use device, miLOOP requires a new purchase for each procedure performed. 

A MATCH FOR MISSION TRIPS

Another use for the miLOOP: mission work. Dr. Patterson learned about the device and began training on it during a medical mission trip to India, before it had been cleared for use by the FDA.

“Cataract is the leading cause of preventable blindness in the world, but there aren’t enough doctors to treat it,” says Dr. Patterson, who says the miLOOP helps for those who struggle with equipment costs associated with mission work abroad. “We have to think about how we can increase access to save people from going blind in a cost-efficient way.” OM

Edward Holland, MD, is a consultant for ianTECH.
Michael Patterson, DO, reports no financial disclosures.

REFERENCE

1. Iancu R, Corbu C. Intraocular pressure after phacoemulsification in patients with uncontrolled primary open angle glaucoma. J Med Life. 2014 Mar 15;7:1-16. www.ncbi.nlm.nih.gov/pmc/articles/PMC3956089 . Accessed May 30, 2018.