Shuang-An Yang1,2, William G Mitchell1,2, Nathan Hall1,3, Tobias Elze1,4, Joan W Miller1,4, Alice C Lorch1,4, Nazlee Zebardast1,4,5. 1. Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA. 2. Harvard TH Chan School of Public Health, Boston, Massachusetts, USA. 3. Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, USA. 4. Glaucoma Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA. 5. Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE: To examine patterns of standard (trabeculectomy or glaucoma drainage devices, GDDs) vs novel (minimally invasive glaucoma surgery, MIGS) surgical techniques in the US. METHODS: We used the American Academy of Ophthalmology (AAO) IRIS® Registry (Intelligent Research in Sight) queried between 2013 and 2018 (inclusive) to calculate the cumulative proportion of stand-alone, concurrent (same day) or sequential (subsequent day) glaucoma surgical techniques performed in each glaucoma diagnosis type. Secondary analyses of adjusted proportions of concurrent and sequential surgeries stratified by glaucoma diagnosis were also performed. RESULTS: Of 203,146 eyes receiving glaucoma surgeries, open angle glaucoma (OAG) was most likely to undergo all types of intervention. The iStent was the most commonly performed MIGS, primarily for those with normal tension glaucoma (NTG) or OAG (p < .001). Conversely, GDD was the most commonly performed procedure in secondary glaucoma or other (specified) glaucoma (p < .001). ECP and iStent were the most common concurrent procedures performed; most often for OAG and NTG (p < .001). After an initial standard surgery, most eyes underwent recurrent standard interventions (90.3%). ECP was the most common MIGS performed after an initial standard surgery; particularly in primary angle-closure (PACG) and secondary glaucoma eyes (p < .001). CONCLUSION: Glaucoma type may influence the choice of glaucoma procedures and the decision to perform concurrent as well sequential surgical procedures. Given the poorly understood long term safety and effectiveness of MIGS, and with substantially increasing use of MIGS procedures in recent years, future studies comparing their safety and effectiveness vs standard interventions, for a variety of glaucoma types, is needed.
PURPOSE: To examine patterns of standard (trabeculectomy or glaucoma drainage devices, GDDs) vs novel (minimally invasive glaucoma surgery, MIGS) surgical techniques in the US. METHODS: We used the American Academy of Ophthalmology (AAO) IRIS® Registry (Intelligent Research in Sight) queried between 2013 and 2018 (inclusive) to calculate the cumulative proportion of stand-alone, concurrent (same day) or sequential (subsequent day) glaucoma surgical techniques performed in each glaucoma diagnosis type. Secondary analyses of adjusted proportions of concurrent and sequential surgeries stratified by glaucoma diagnosis were also performed. RESULTS: Of 203,146 eyes receiving glaucoma surgeries, open angle glaucoma (OAG) was most likely to undergo all types of intervention. The iStent was the most commonly performed MIGS, primarily for those with normal tension glaucoma (NTG) or OAG (p < .001). Conversely, GDD was the most commonly performed procedure in secondary glaucoma or other (specified) glaucoma (p < .001). ECP and iStent were the most common concurrent procedures performed; most often for OAG and NTG (p < .001). After an initial standard surgery, most eyes underwent recurrent standard interventions (90.3%). ECP was the most common MIGS performed after an initial standard surgery; particularly in primary angle-closure (PACG) and secondary glaucoma eyes (p < .001). CONCLUSION: Glaucoma type may influence the choice of glaucoma procedures and the decision to perform concurrent as well sequential surgical procedures. Given the poorly understood long term safety and effectiveness of MIGS, and with substantially increasing use of MIGS procedures in recent years, future studies comparing their safety and effectiveness vs standard interventions, for a variety of glaucoma types, is needed.
Entities:
Keywords:
Cypass; Minimally invasive glaucoma surgery; Xen gel stent; canaloplasty; endocyclophotocoagulation; goniotomy; iStent microstent; open angle glaucoma
Authors: Colin Clement; Frank Howes; Alexandros Ioannidis; Michael Shiu; David Manning; Jed A Lusthaus; Simon E Skalicky; Todd W Goodwin Journal: Clin Ophthalmol Date: 2022-09-01
Authors: Cecilia S Lee; Marian Blazes; Alice Lorch; Suzann Pershing; Leslie Hyman; Allen C Ho; Julia Haller; Joan W Miller; Emily Y Chew; Flora Lum; Aaron Y Lee Journal: Ophthalmol Sci Date: 2022-01-08