Surgical Options for Patients With Cataracts and Open-Angle Glaucoma

Recent studies evaluated the efficacy of MIGS combined with phacoemulsification.

Maxwell de la Paz, BS, and Linda M. Tsai, MD

Cataract and Refractive Surgery Today

Key Takeaways Recent studies have evaluated the efficacy of MIGS combined with phacoemulsification in eyes with open-angle glaucoma. Trabecular procedures combined with cataract surgery provided a greater IOP reduction than cataract surgery alone in patients with hypertensive open-angle glaucoma. Compared to phacoemulsification alone, combining the procedure with MIGS appeared to provide a greater reduction in IOP and the number of medications required postoperatively without decreasing safety. Trabecular Procedures Combined with Cataract Surgery for Open- Angle Glaucoma: A Report by the American Academy of Ophthalmology Richter GM, Takusagawa HL, Sit AJ, et al1Industry support for this study: None ABSTRACT SUMMARY This report compared the IOP reduction of various trabecular procedures combined with cataract surgery to that of cataract surgery alone in patients with hypertensive open-angle glaucoma (OAG). Patient-specific considerations that might guide procedure selection were also investigated. STUDY IN BRIEF A report drawing on 10 randomized controlled trials found that combining trabecular procedures with cataract surgery provided a greater IOP reduction than cataract surgery alone in patients with hypertensive open-angle glaucoma. The trabecular procedures themselves showed no clear benefits over one another for IOP or medication reduction, but direct comparison studies are required. The risks of uveitis and bleeding were among the factors that might influence surgeons’ choice of trabecular procedure. WHY IT MATTERS In patients with well-controlled hypertensive open-angle glaucoma, cataract surgery may reduce their medication burden by 0.8 to 1 at 2 years. When cataract surgery is combined with a trabecular procedure, a further 0.4-reduction may occur.1,2 Because the combined trabecular procedures in this AAO report offered similar benefits, patient factors and surgeon preference may be more important when offering specific options.

The Patient Who Never Came Back

Closing gaps in glaucoma care is no longer optional.

Joe Casper, MBA, COE

Cataract and Refractive Surgery Today

Key Takeaways Many patients are unaware that they have glaucoma until it has decreased their vision. When patients fail to return for recommended testing and procedures, they may drift off the schedule. Closing care gaps can improve the quality of care delivered and revenue per encounter, particularly in clinics where time rather than demand is the limiting factor. Technological advances in ophthalmology often emphasize innovation, but are practitioners implementing these advances effectively? This month’s column focuses on the importance of embracing appropriate diagnostic protocols to ensure that technological progress benefits patients with glaucoma. At Brevium, Joe Casper, MBA, COE, focuses on implementing advanced data intelligence software to optimize patient recapture strategies. Data-driven insights can be used to improve care outcomes, increase operational efficiency, and support practice revenue growth. -Tracy J. Kenniff, MBA, OCS Unless they are experiencing an acute angle-closure attack, many patients are unaware that they have glaucoma until it has decreased their vision. My aunt is a case in point.

Dislocated IOL

Eyetube