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Surgeon weighs pros and cons of IOP-lowering technique
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DANA POINT, Calif. — Surgeons should consider factors such as efficacy, safety, ease of use, shorter operative time and reimbursability when adding a new procedure, such as Trabectome (NeoMedix), to a surgical repertoire for reducing IOP, according to L. Jay Katz, MD, speaking at the American Glaucoma Society meeting.
"Trabectome is a reasonable choice for select candidates," Dr. Katz said, noting the positive and negative aspects of undertaking this procedure.
On the plus side, safety, ease of use, shorter operative time and reimbursability all are positive.
"Short term, there are no worries about subconjunctival wound modulation, and long term, there are no bleb concerns," he said of the technique's concept.
On the minus side, efficacy in lowering IOP "is not quite what you would expect with trabeculectomy, but nevertheless pretty good," he said.
"Although you get a modest but effective pressure reduction, a lot of these patients are kept on glaucoma medication postoperatively," he said. "That's an important point to consider."
Citing a study of more than 500 patients in which one measure of success was IOP less than 21 mm Hg, or at least a 20% drop below baseline, Dr. Katz said success rate was 65% at 1 year, with about a 31% pressure reduction. However, mean reduction was modest, and many patients have to be maintained on glaucoma medicine, he said.
- Disclosure: Dr. Katz reports financial relationships with Alcon, Allergan, Glaukos, Heidelberg, Lumenis, Merck and Pfizer.