Our Summary

This research paper looks at the different types of surgical techniques used to treat glaucoma in the US, using data from the American Academy of Ophthalmology’s IRIS Registry between 2013 and 2018. There are traditional methods of surgery, like trabeculectomy or glaucoma drainage devices (GDDs), and newer, less invasive methods, referred to as minimally invasive glaucoma surgery (MIGS).

The study found that the type of glaucoma a patient has may influence the type of surgery they receive. For example, patients with open angle glaucoma (OAG) were most likely to receive all types of interventions. The most common MIGS performed was the iStent, especially for those with normal tension glaucoma (NTG) or OAG. On the other hand, GDD was the most common procedure for secondary glaucoma or other specific types of glaucoma.

The study also found that after a traditional surgery, most patients received more traditional interventions (90.3%). However, the most common MIGS performed after a traditional surgery was endocyclophotocoagulation (ECP), particularly in primary angle-closure (PACG) and secondary glaucoma cases.

The researchers concluded that further studies are needed to compare the safety and effectiveness of MIGS to traditional methods, given the increasing use of MIGS and the lack of long-term safety and effectiveness data.

FAQs

  1. What are the different types of surgical techniques used to treat glaucoma?
  2. How does the type of glaucoma a patient has influence the type of surgery they receive?
  3. What further research is needed regarding minimally invasive glaucoma surgery (MIGS)?

Doctor’s Tip

A helpful tip a doctor might tell a patient about glaucoma surgery is to follow their post-operative care instructions closely to ensure proper healing and prevent complications. This may include using prescribed eye drops, avoiding strenuous activities, and attending follow-up appointments as scheduled. It is also important to report any changes in vision or increased eye pain to your doctor immediately.

Suitable For

Overall, patients with various types of glaucoma may be recommended for surgery based on factors such as the severity of their condition, response to other treatments, and individual preferences. It is important for ophthalmologists to consider the specific characteristics of each patient’s glaucoma when recommending a surgical intervention, in order to achieve the best possible outcomes.

Timeline

Before glaucoma surgery, a patient typically undergoes a comprehensive eye exam to assess the severity of their condition and determine the most suitable treatment option. The ophthalmologist may also perform additional tests such as visual field testing, optical coherence tomography (OCT), and intraocular pressure measurements.

After glaucoma surgery, patients may experience some discomfort, redness, and blurred vision in the days following the procedure. They will be prescribed eye drops to prevent infection and reduce inflammation. It is important for patients to follow their post-operative care instructions, which may include avoiding strenuous activities, keeping the eye clean, and attending follow-up appointments.

In the weeks and months after surgery, patients will have regular check-ups with their ophthalmologist to monitor their eye pressure and overall eye health. It may take some time for vision to stabilize and for the full benefits of the surgery to be realized. Patients should continue to use their prescribed eye drops as directed and report any new or worsening symptoms to their healthcare provider.

What to Ask Your Doctor

Some questions a patient should ask their doctor about glaucoma surgery include:

  1. What type of glaucoma do I have, and how will that affect the type of surgery I need?
  2. What are the potential risks and complications associated with the surgery you are recommending?
  3. What is the success rate of this surgery in patients with my type of glaucoma?
  4. What is the recovery process like after the surgery, and how long will it take for me to see the results?
  5. Are there any alternative treatments to surgery that I could consider?
  6. Will I need to take any medications or undergo additional treatments after the surgery?
  7. How often will I need to follow-up with you after the surgery?
  8. Are there any lifestyle changes I should make to help improve the outcome of the surgery?
  9. What is the long-term outlook for my vision after this surgery?
  10. Are there any clinical trials or newer technologies that I should consider for my glaucoma treatment?

Reference

Authors: Yang SA, Mitchell WG, Hall N, Elze T, Miller JW, Lorch AC, Zebardast N. Journal: Ophthalmic Epidemiol. 2022 Aug;29(4):443-451. doi: 10.1080/09286586.2021.1955391. Epub 2021 Jul 26. PMID: 34311672