Our Summary

This research paper looked at the effectiveness and long-term costs of different types of minimally invasive glaucoma surgeries (MIGSs) used in combination with cataract surgery for patients with primary open-angle glaucoma (POAG). The study found that using two trabecular micro-bypass stents during cataract surgery was the most effective and cost-efficient treatment, especially when used in the moderate stage of the disease rather than waiting until it advances. This treatment resulted in the largest reduction in intraocular pressure (the pressure inside the eye), which is a key indicator of the disease.

FAQs

  1. What types of minimally invasive glaucoma surgeries were studied in the research?
  2. According to the study, when is the most cost-effective time to use two trabecular micro-bypass stents during cataract surgery?
  3. How does the study measure the effectiveness of different treatments for primary open-angle glaucoma (POAG)?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to discuss the option of using two trabecular micro-bypass stents during cataract surgery, as this treatment has been found to be the most effective and cost-efficient for patients with primary open-angle glaucoma. It is important to consider this treatment earlier rather than waiting until the disease advances to achieve the best results in reducing intraocular pressure.

Suitable For

Patients with primary open-angle glaucoma, particularly those in the moderate stage of the disease, are typically recommended glaucoma surgery such as trabecular micro-bypass stents in combination with cataract surgery. These patients may have not responded well to other treatments, such as medications or laser therapy, and may require a more invasive surgical option to help lower intraocular pressure and preserve their vision. Additionally, patients who are at risk of vision loss or who have significant damage to their optic nerve may also be recommended for glaucoma surgery to prevent further progression of the disease.

Timeline

Timeline before and after glaucoma surgery:

Before surgery:

  1. Patient is diagnosed with primary open-angle glaucoma (POAG) and undergoes various tests to determine the severity of the disease.
  2. Patient may be prescribed various medications to help lower intraocular pressure and manage symptoms.
  3. Patient may undergo regular follow-up appointments to monitor the progression of the disease.

After surgery:

  1. Patient undergoes cataract surgery with the insertion of trabecular micro-bypass stents to help lower intraocular pressure.
  2. Patient may experience some discomfort and blurred vision immediately after surgery, which typically improves within a few days.
  3. Patient may need to use eye drops and follow a specific post-operative care regimen to ensure proper healing and prevent complications.
  4. Patient will have follow-up appointments to monitor the success of the surgery and make any necessary adjustments to the treatment plan.
  5. Over time, patient may experience improved vision and reduced symptoms of glaucoma, leading to a better quality of life.

What to Ask Your Doctor

  1. What are the different types of glaucoma surgeries available and which one do you recommend for my specific case?

  2. What are the potential risks and complications associated with glaucoma surgery?

  3. How long is the recovery period after glaucoma surgery and what can I expect during this time?

  4. Will I still need to use eye drops or other medications after glaucoma surgery?

  5. What are the success rates of the different types of glaucoma surgeries and how long do the effects typically last?

  6. How often will I need follow-up appointments after glaucoma surgery to monitor my condition?

  7. Are there any lifestyle changes or precautions I should take after undergoing glaucoma surgery?

  8. Will I need to undergo any additional treatments or surgeries in the future to manage my glaucoma?

  9. How will glaucoma surgery affect my vision and overall eye health in the long term?

  10. Are there any alternative treatments or therapies available for my glaucoma that I should consider before opting for surgery?

Reference

Authors: Bartelt-Hofer J, Flessa S. Journal: Int Ophthalmol. 2020 Jun;40(6):1469-1479. doi: 10.1007/s10792-020-01314-7. Epub 2020 Mar 17. PMID: 32185590