When I first met Arsham Sheybani MD at a meeting a few years ago, I could tell that I was in the presence of greatness. He was brilliant and innovative, but also very kind and a great teacher. He recently described the BANG technique which is the Bent Ab-interno Needle Goniectomy MIGS procedure that is very low cost. All you need is a 25g or 27g needle (5/8 inch is preferred since 1/2 inch may be too short) and a needle holder to bend the tip. The goal is to bend the tip at about a 75 to 80 degree angle and then perhaps to put another slight curve at the very tip. This can then be used to perform a goniectomy for about 100 degrees using a gonioprism at the conclusion of cataract surgery. This results in a reduction of IOP of about 30% and a reduction of medication load for these glaucoma patients. In this video, Dr Sheybani shows us his very first inaugural BANG procedure then gives great pearls for success and finally, we see Dr Sheybani’s fellow performing his/her first BANG procedure as well. We have always said that hands are more important than machines/instruments, and this video is proof of that.
click to learn the BANG glaucoma MIGs procedure from the innovator himself: