Our Summary
Glaucoma is a disease that damages the eye’s optic nerve and can lead to vision loss. The standard treatments are eye drops, laser treatment, or surgery that lowers the pressure in the eye. A new type of less invasive surgery (MIGS) has been gaining popularity because it can also lower eye pressure but without as many complications as traditional surgery or the need for patients to remember to use eye drops.
In this study, the researchers looked at the medical records of all patients who had MIGS at the University Hospital of Iceland from January 2019 to June 2020. They excluded anyone who had already had glaucoma surgery or who had a different type of glaucoma. They divided the results into two groups: those who had MIGS with a cataract surgery technique called phacoemulsification and those who had MIGS only.
They studied 112 eyes from people aged around 74.5 years. The average severity of their vision loss (measured by a score called the MD score) was 8.8 and they were on an average of 1.8 glaucoma medications. The researchers found significant differences between the two groups in terms of age, MD score, and number of glaucoma medications.
They also found a significant difference in the MD score between eyes with a common type of glaucoma, called primary open angle glaucoma, and a less common type called pseudoexfoliation glaucoma.
The study concluded that patients referred to surgery had less severe vision loss and were on fewer medications compared to a similar study done in Iceland three years earlier. This may suggest that Icelandic doctors are referring patients for surgery earlier, particularly those with pseudoexfoliation glaucoma.
FAQs
- What is the new type of less invasive surgery for glaucoma?
- What were the main findings of the study conducted at the University Hospital of Iceland on MIGS?
- Has the referral pattern for glaucoma surgery changed in Iceland based on the study’s findings?
Doctor’s Tip
A helpful tip a doctor might tell a patient about glaucoma surgery is that it is important to follow post-operative care instructions carefully to ensure the best possible outcome. This may include using prescribed eye drops, attending follow-up appointments, and avoiding activities that could increase eye pressure. It is also important to communicate any changes in vision or symptoms to your doctor promptly.
Suitable For
Typically, patients who are recommended glaucoma surgery are those who have not responded well to other treatments such as eye drops or laser treatment, have significant vision loss, are on multiple glaucoma medications, and have a type of glaucoma that is progressing despite treatment. In this study, patients with less severe vision loss and fewer medications were also referred for surgery, suggesting that doctors may be considering surgery earlier in the disease process.
Timeline
Before glaucoma surgery, a patient may experience worsening vision loss, increased reliance on glaucoma medications, and potentially worsening symptoms of the disease. They may also have consultations with their eye doctor to discuss the risks and benefits of surgery.
After glaucoma surgery, patients may experience improvements in their vision, a reduction in the need for glaucoma medications, and a decreased risk of further vision loss. They may also have follow-up appointments with their eye doctor to monitor their progress and ensure that the surgery was successful in lowering their eye pressure and preserving their vision.
What to Ask Your Doctor
Some questions a patient should ask their doctor about glaucoma surgery include:
- What type of glaucoma surgery do you recommend for my specific condition?
- What are the potential risks and complications associated with the surgery?
- How successful is this type of surgery in lowering eye pressure and preserving vision?
- What is the recovery process like after the surgery?
- Will I still need to use eye drops after the surgery?
- How often will I need to follow up with you after the surgery?
- Are there any alternative treatments or surgeries that I should consider?
- How experienced are you in performing this type of surgery?
- Are there any specific lifestyle changes or precautions I should take after the surgery?
- What are the long-term outcomes and expectations for my vision after the surgery?
Reference
Authors: Jonsson DT, Olafsdottir OB, Gottfredsdottir MS. Journal: Laeknabladid. 2022 Dec;108(12):547-551. doi: 10.17992/lbl.2022.12.720. PMID: 36454052