Interventional Glaucoma

Steven Vold, MD, reports that toric IOLs provide an accurate, safe, and convenient way to correct astigmatism and uncorrected distance vision for glaucoma patients, while patients wanting presbyopic correction have IOL options to fit a range of visual needs.

Until now, surgery has been considered a second-line treatment after medication and lasers because of the risks associated with trabeculectomy and tube shunts. Now ophthalmologists can draw from a larger surgical tool chest, explains Iqbal Ike K. Ahmed, MD.

Advances in phacoemulsification are creating new opportunities for glaucoma surgery, especially in developing countries, according to Alan S. Crandall, MD.

One laboratory is at work on new devices that use visual stimuli to prompt retinal ganglion cells to regenerate, while two other researchers describe techniques through which virtual reality might diagnose the disease more accurately than standard automated perimetry.

One laboratory is at work on new devices that use visual stimuli to prompt retinal ganglion cells to regenerate, while two other researchers describe techniques through which virtual reality might diagnose the disease more accurately than standard automated perimetry.

In addition to making use of MIGS, interventional glaucoma might utilize other novel drainage devices and sustained drug-delivery devices and be combined with cataract surgery. This approach is more proactive, aims at lower IOP, lowers risk and addresses adherence, said Iqbal Ike K. Ahmed, MD.

Glaucoma 360, a three-day event being held here by the Glaucoma Research Foundation (GRF), will move from its "Celebrate" phase with Annual Gala on Thursday into its "Innovate" phase with the New Horizons Forum set for today. This event is a full day of presentations, panels, and discussions featuring leaders from start-up companies, industry executives, ophthalmic experts, venture capitalists, and the FDA.

Glaucoma 360, a three-day event organized by the Glaucoma Research Foundation (GRF) will move into its final day on Saturday with the Glaucoma Symposium. The focus will shift from "Innovate" to "Educate." Two continuing medical education sessions are-one for ophthalmologists in the morning and another for optometrists in the afternoon.

A portable device for detecting multifocal steady-state visual evoked potentials associated with visual field stimulation is being developed as an objective test for identifying glaucoma-related visual function loss.

A review of glaucoma drugs in various clinical study phases reveals that at least seven new glaucoma drugs were in trials and two others were approved by the FDA in 2017. Many drugs that have progressed the most act on prostaglandin receptors, though some combine this with other mechanisms of action.

When customizing treatment plans for glaucoma patients, selective laser trabeculoplasty (SLT) can be as useful in diagnosis as it is in reducing IOP, explains Inder Paul Singh, MD, FEBOphth.

The 2017 Charles D. Kelman Lecture touched on three main areas-from the teaching of the phaco technique during the early years of phaco to use of phaco in glaucoma patients to the introduction of phaco to surgeons in developing countries.

A prospective, observational study found that eyes with mild POAG could be differentiated from pre-perimetric glaucomatous eyes, which also could be differentiated from normal eyes using OCTA-derived retinal vessel density measurements.

A new imaging technique can show the deaths of individual cells in people with glaucoma by labelling the cells with fluorescent dye, according to researchers. The approach might eventually be used to diagnosis the disease in its early stages or measure its progression.

Prostaglandin-based topical therapy has been the ‘go-to treatment’ for open-angle glaucoma for decades. In contrast, laser trabeculoplasty has conventionally remained reserved for patients unresponsive or unable to adhere to medication-based therapy.

For 20 years I have effectively employed endoscopic cyclophotocoagulation (ECP) as a primary or secondary line of glaucoma treatment. ECP is a minimally invasive glaucoma surgical (MIGS) option capable of reducing IOP in the majority of patients and can potentially eliminate the need for drainage surgery, including trabeculectomy (trab) and glaucoma drainage devices (GDDs).

Despite the legalization of marijuana by several state governments, physicians should not recommend smoking it as a treatment for glaucoma, said Sunita Radhakrishnan, MD. “It has been approved by public opinion rather than regulatory process,” said Sunita Radhakrishnan, MD. 

Reading speed is reduced in patients with glaucomatous visual field loss and normal visual acuity, and the reduction in performance is directly proportional to the extent of the visual field loss, said Aron Guimaraes, MD.

As more state legislatures are relaxing anti-marijuana laws, doctors are being put in the middle by patients requesting prescriptions or authorizations for its use for medical needs, said Marc F. Lieberman, MD.

Research in glaucoma that evaluates the molecular interactions between resident and systemic immune cells and neurons is progressing with the goal of providing translational applications for immunomodulation as a neuroprotective strategy in patients with glaucoma, said Gülgün Tezel, MD.

A glaucoma specialist explores endoscopic visualization for the diagnosis and treatment of uveitic-glaucoma-hyphema syndrome.

Although surgical intervention is not always necessary in eyes with choroidal detachment, drainage should be performed if spontaneous resolution does not occur in order to restore normal anatomy and prevent trabeculectomy failure.

Hydrogel punctal plugs may be a safe and viable method for delivery of anti-glaucoma drugs in the future.

An investigational glaucoma device that shunts aqueous from the anterior chamber to a sub-conjunctival/sub-Tenon’s pouch is being evaluated in a prospective study of 35 eyes operated on at two centers.

A nanophotonics-based device implanted in the eye may one day enable patients with glaucoma to monitor their IOP from home.

Advances in ultrasound biomicroscopy enable the capture of higher quality images to ophthalmic surgeons who seek accurate diagnoses or anatomic measurements.

The "Glaucoma 360 Annual Gala" raises money for GRF research and education. The gala includes a reception, silent and lives auctions, dinner, entertainment, and awards. For a glimpse of the evening's festivities, view the slide show.

The advent of 24-hour IOP monitoring will transform the care of patients with glaucoma and usher in a new era of personalizing IOP.24-hour IOP monitoring set to revolutionize glaucoma research and clinical care.

Increased patients and patient access, new payment models, and the rise of comparative effectiveness research top the list of challenges that ophthalmologists will face in the future, according to William L. Rich, III, MD, FACS.