New World Medical (NWM) has launched an upgraded STREAMLINE Surgical System with improved visualization for stand-alone use or in combination with other ocular surgeries, including cataract surgery.
How exciting … but didn’t the company just have a surgical system update?
Not exactly recently, but yes, within the last 2 months (February 2025).
However, that announcement was for a different system: the VIA360 Surgical System.
- The news: The FDA granted clearance to VIA360, a delivery system for viscoelastics (ophthalmic viscosurgical devices [OVDs]).
Gotcha. Let’s start, then, with the original STREAMLINE system.
As the foundation for this upgraded version, the STREAMLINE was originally granted FDA 510(k) clearance in October 2021 before launching to the U.S. commercial market in April 2022.
Its purpose: The implant-free, minimally-invasive system creates precise goniotomies in the trabecular meshwork (TM) and delivers small amounts of OVDs into Schlemm’s canal—all in one step.
And what technology does it utilize?
That would be NWM’s proprietary ClickPulse Technology, which provides a controlled, targeted delivery of viscoelastic—with a reported (up to) eight applications per procedure, according to the company.
Next: its indications.
The system is indicated to treat ocular hypertension and open-angle glaucomas.
Specifically: Surgeons can use this single-use device as either a stand-alone procedure or combined with ophthalmic surgery (including cataract).
- See here for a more detailed (and visual) rundown of how this works.
Give me a rundown on how the device is designed.
With ergonomics in mind, the hand-held device features a:
- Outer sleeve contained within a pump system that smoothly retracts and is used as a positioning aid under gonioscopic visualization
- Priming port designed for luer fitting of an external syringe and loading the viscoelastic
- Actuator button that, when pressed, initiates the ClickPulse technology and activates the pump to retract the outer sleeve
- During this process, the inner cannula is exposed to create an incision and deliver (inject) a precise amount of viscoelastic fluid
How many times can this be performed?
According to reports, surgeons can perform three or more punctures of the TM—spanning at least 90° to dilate Schlemm’s canal.
And take note: When the actuator button is pressed, 7 microliters (mL) of viscoelastic are delivered, with a maximum of eight deliveries possible per a single device.
And is there any clinical data on it?
Indeed there is. In fact, a 2024 study published in Clinical Ophthalmology evaluated 12-month outcomes in the eyes of Hispanic adult patients with glaucoma who underwent canaloplasty via the STREAMLINE combined with phacoemulsification.
- The findings: STREAMLINE canaloplasty with phaco resulted in a “clinically and statistically significant reduction in [intraocular pressure (IOP)] and IOP-lowering medications.”
And prior to that research: A 2022 study published in the same journal concluded similar findings—see those details here.
Alrighty, now how is this next-gen STREAMLINE different from the original?
The upgraded device is equipped with the same capabilities—plus the addition of one major new feature: A transparent tip.
What this enables: Improved visualization of key anatomical structures throughout the procedure.
Very cool … and lastly: How can I add this to my practice?
Click here to contact the company about details on certification and product purchases.