Providing premium IOL care
Patients want premium IOLs. They want better vision and they do not want to use drops. Word of mouth is powerful, and patients who hear about a procedure that will reduce or eliminate drops will come.
Physicians need to stay up-to-date, both to remain relevant in today’s world and to provide the best possible care for patients. It is imperative to keep up with the times and changing technology to better serve the patients.
If a surgeon has abandoned the technology because of problems inserting the stent, I recommend working with a successful surgeon on the technique and try again. Both physicians and patients will find it worthwhile.
In today’s environment, not offering a MIGS procedure to a patient who is undergoing cataract surgery is a missed opportunity. In the United States, most MIGS procedures are indicated during cataract surgery.
If that window is missed, surgeons have missed this opportunity to help the patient. Physicians should do all in their power to help patients. Therefore, when implanting an IOL to improve patient vision, surgeons cannot forget to treat the glaucoma as well.
Samuelson TW, Katz LJ, Wells JM, Duh YJ, Giamporcaro JE, US iStent Study Group. Randomized evaluation of the trabecular micro-bypass stent with phacoemulsification in patients with glaucoma and cataract. Ophthalmology 2011;118:459-467.
Arriola-Villalobos P, Martínez-de-la-Casa JM, Díaz-Valle D, et al. Combined iStent trabecular micro-bypass stent implantation and phacoemulsification for coexistent open-angle glaucoma and cataract: a long-term study. Br J Ophthalmol. 2012;96(5):645-9.
Fea A. M., Consolandi G., Zola M., et al. Micro-bypass implantation for primary open-angle glaucoma combined with phacoemulsification: 4-year follow-up. Journal of Ophthalmology. 2015;2015:4. doi: 10.1155/2015/795357.795357
Neuhann T. H. Trabecular micro-bypass stent implantation during small-incision cataract surgery for open-angle glaucoma or ocular hypertension: long-term results. Journal of Cataract & Refractive Surgery. 2015;41(12):2664–2671. doi: 10.1016/j.jcrs.2015.06.032.
Malvankar-Mehta M. S., Iordanous Y., Chen Y. N., et al. iStent with phacoemulsification versus phacoemulsification alone for patients with glaucoma and cataract: a meta-analysis. PLoS ONE. 2015;10(7) doi: 10.1371/journal.pone.0131770.e0131770.