MIGS should be considered in glaucoma patients undergoing cataract surgery


March 23, 2023

1 minute read


Source/Disclosure

sauce:

Conner I. Is offering MIGS in cataract surgery the “standard of care”? Presented at: American Glaucoma Society. March 2-5, 2022. Austin, Texas.


Disclosure: Conner previously consulted for Ivantis and reportedly had an ownership interest in Ocugenix.


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Important points:

  • MIGS with cataract surgery is effective, safe, and cost-effective.
  • Consideration of MIGS in every glaucoma patient undergoing cataract surgery should become the standard of care.

Considering minimally invasive glaucoma surgery alongside cataract surgery should be the standard of care for cataract surgeons, according to a speaker at the American Glaucoma Society.

“The bottom line is that MIGS should not necessarily be offered to all glaucoma patients undergoing cataract surgery, but it really needs to be considered in the context of the patient’s individual circumstances.” Ian Konger, MD, PhD, Said.



cataract eye 1
Considering minimally invasive glaucoma surgery alongside cataract surgery should be the standard of care for cataract surgeons, according to a speaker at the American Glaucoma Society.
Image: Adobe Stock

According to Conner, the primary goal when performing MIGS in cataract surgery is to better control IOP and reduce the medication burden.

A previous study found that the angle-based implant MIGS procedure was safe and effective, with no significant difference in complications between phacoemulsification alone and phacoemulsification with device implantation.

Importantly, Conner said MIGS is cost effective. For example, in one study, a cataract patient who underwent phacoemulsification and his MIGS compared with patients who underwent phacoemulsification alone and those who received medication alone, was found to be “compared to cost”. demonstrated a very high quality of life.

Common barriers faced by cataract surgeons in incorporating MIGS into their practice on a regular basis include the discomfort of surgical gonioscopy, reimbursement concerns, and additional operative time.

“What we’ve found is that in experienced hands, any of these steps can usually be done in less than five minutes,” he said.

When choosing the appropriate MIGS procedure for each patient, the surgeon should assess the patient’s demographics, glaucoma type and severity, cataract and anticoagulant status, and the need to minimize medication for each patient.

“Offering MIGS in cataract surgery is not yet standard practice, but it probably should be,” said Conner.

References:

  • Ahmed IIK, et al. Ophthalmology. 2020; doi:10.1016/j.ophtha.2019.04.034.
  • Ahmed IIK, et al. Ophthalmology. 2022; doi:10.1016/j.ophtha.2022.02.021.
  • Gede SJ, et al. Ophthalmology2021;doi:10.1016/j.ophtha.2020.10.022.
  • Rowson AC, et al. J Climmed2022; doi:10.3390/jcm11226833.
  • Sood S and others ophthalmology glaucoma2021;doi:10.1016/j.ogla.2021.09.006.



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