Blazing a Trail
The future of glaucoma surgery.
Its evolution sparked in 2004 by the FDA’s approval of the Trabectome (NeoMedix), microinvasive glaucoma surgery (MIGS) is here to stay. Lowering IOP safely and significantly without the formation of a filtration bleb was and remains a novel, exciting concept for glaucoma patients all over the world. The idea of surgically intervening early in the disease process has challenged long-standing treatment paradigms that often included using four to five topical glaucoma medications and performing laser trabeculoplasty before considering incisional glaucoma surgery. The FDA’s approval of the iStent Trabecular Micro-Bypass Stent (Glaukos) in 2012 and the CyPass Micro-Stent (Alcon) and Xen Glaucoma Treatment System (Allergan) in 2016 has expanded the role of MIGS across the spectrum of glaucoma. Not long ago, today’s reality would have been deemed a fairy tale.
In this special issue of GT, experienced and thoughtful ophthalmologists explore where surgery fits in glaucoma management. They share current data and their thoughts on a wide variety of MIGS procedures—some FDA approved and others under investigation—to highlight their increasing relevance to patients. Contributors also examine current options for laser therapy.
Although the story of the role and techniques of glaucoma surgical intervention are still being written, it has the capacity to change forever how providers talk with and care for glaucoma patients.
—Steven D. Vold, MD, chief medical editor