Best of 2023: Glaucoma
Video Roundtable: What’s Next in Glaucoma Management
Ophthalmologists, Manjool Shah, Arkadiy Yadgarov, and Morgan Micheletti, discuss the current state of glaucoma management and the role of interventional approaches, delving into the challenges of traditional glaucoma treatment methods, such as medication, and highlights the need for more effective solutions. The doctors discuss their experiences with glaucoma interventions, particularly the use of iStent Infinite, a standalone micro-invasive glaucoma surgery (MIGS) device. They emphasize the importance of patient education, early intervention, and the potential benefits of MIGS in improving patients’ quality of life while managing glaucoma. The discussion also touches on the cost-effectiveness of interventional procedures compared to traditional treatments like eye drops.
The Synergy of MIGS and Cornea Specialists: Advancing Glaucoma Treatment and Improving Quality of Life
The article underscores the transformative impact of minimally invasive glaucoma surgery (MIGS) as an innovative and effective treatment for glaucoma, particularly when integrated with cataract surgery. Cornea specialists, such as Dr. Himani Goyal, emphasize that MIGS offers a unique opportunity to address various aspects of glaucoma treatment concurrently, effectively lowering intraocular pressure and reducing the need for medications. The focus on preserving corneal health is highlighted, with MIGS providing a beneficial alternative to long-term use of topical medications that can adversely affect the ocular surface. The integration of MIGS into the practice of cornea specialists expands their scope of care, potentially increasing patient satisfaction. Despite a learning curve, the article stresses that mastering MIGS procedures is within the skill set of cornea specialists, offering a comprehensive approach to eye care that improves patient outcomes, vision, and overall quality of life.
Streamline procedure with phacoemulsification significantly reduces IOP in OAG
The study presented at the 2023 American Glaucoma Society Annual Meeting reveals that the Streamline surgical system, when combined with phacoemulsification, significantly reduces intraocular pressure (IOP) in patients with mild to severe open-angle glaucoma. Analyzing 38 eyes from 26 patients, the surgical success rate at 6 months postoperatively was 66.7%, with a notable decrease in baseline mean IOP and sustained reduction in medication use. The procedure demonstrated efficacy in lowering IOP and minimizing medication dependence, and while a single case experienced an IOP spike, promptly managed with topical medications, no other complications were reported, suggesting favorable outcomes for patients undergoing the Streamline surgical system alongside phacoemulsification for open-angle glaucoma treatment.
Impact of Medicare reimbursement cuts on glaucoma procedures discussed at AAO 2023
Recent CMS Medicare reimbursement cuts to minimally invasive glaucoma surgery (MIGS) have led to significant shifts in surgical practices within the field of ophthalmology, according to a paper presented at AAO 2023. The study found that procedures involving Hydrus and iStent experienced a notable decrease, while goniotomy and canaloplasty procedures saw significant increases.
