According to Dr Razeghinejad et al, since 1856—when Albrecht von Graefe discovered that iridectomy was an effective surgical method for acute glaucoma treatment—many new surgeries have been devised. Two years following Dr von Graefe’s achievements, Louis De Wecker presented sclerotomy as a procedure for chronic glaucoma and in 1900, internal filtration (cyclodialysis) was developed.
Although the majority of surgeries used nowadays were introduced in the 1960s, their roots can be traced to the work of surgeons in the 19th century.1 In a bid to mitigate the intra- and post-operative complications associated with glaucoma surgery, there have been some recent new additions to the story. For example, new minimally invasive glaucoma surgeries (MIGS) have been developed from devices such as the Trabectome (NeoMedix Inc), the iStent (Glaukos), the Hydrus (Ivantis) and the CyPass Suprachoroidal Microstent (Transcend Medical).2,3
Today, newer MIGS are designed to offer the same benefits as traditional surgeries but with faster patient recovery (the injectable technique is tissue-sparing and minimally invasive5 compared with classic filtration surgery), less intensive post-operative procedure follow-up and fewer initial appointments in the first month(s) after the procedure.6,7,8
While MIGS are sometimes costly, a recent study reported an IOP reduction of around 30%. In addition, 2.9 fewer glaucoma medications per patient at one year were required.4 So, according to Dr Ike Ahmed, a LASIK surgeon in Canada: “The overall life and eye-health benefits often outweighs the costs of surgery, depending on where you are in the world.”