Registry study shows MIGS for secondary glaucoma is failure-free for most at nearly 2 years
David Friedman, MD, PhD, MPH, and co-author, Asahi Fujita, MD, both of Mass Eye and Ear, detailed findings from their registry study presented at the AGS 2026 Annual Meeting. They found that trying less invasive surgery first in patients with secondary glaucoma could be an option for this patient population.
Asahi Fujita, MD:
In this paper, using the IRIS Registry, which is a nationwide ophthalmic registry, we evaluated the outcomes of glaucoma surgeries among young adults with secondary glaucoma. We did this research because the outcomes of glaucoma surgeries among this population has not been investigated very well. That’s why we did this. We included 2,500 eyes, and we defined failure as having either 1 of the following criteria: number 1, insufficient IOP reduction; number 2, hypotony; number 3, additional IOP-lowering surgeries; and number 4, development of no light perception. We found that, among eyes with steroid-induced glaucoma, two-thirds of the eyes remained failure-free following trabeculectomy, but about 10% of those eyes experienced hypotony. MIGS has been considered as less effective for traumatic glaucoma, but in our analysis, about half of the eyes remained failure-free at 2 years.
David Friedman, MD, PhD, MPH:
That was also true with steroid-induced glaucomas. We were able to get decent pressure lowering, at least for a couple of years, in many of these other forms of secondary glaucoma, such as steroid-induced, traumatic. I think what we found here gives an option and shows that it can work to trying less invasive surgery first in some of these secondary glaucomas where some people tend to think they won’t work, and that was, I think, an important finding. We need to extend it for longer time to see how long we can get. But certainly, it can buy a few years, which is highly valuable to the patient, right?
Asahi Fujita, MD:
Yes. Even though trabeculectomy is effective in reducing IOP, it sometimes causes hypotony, so we have to be careful about that.
David Friedman, MD, PhD, MPH:
Yeah. These secondary glaucomas are probably at higher risk of hypotony because they start at such a high pressure, and if you allow too much out too quickly, you can get very low pressures.
Related Content
