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Speaker outlines ideal candidate for Trabectome
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WASHINGTON — Treatment starts with patient selection, Brian A. Francis, MD, MS, said, giving pearls for introducing Trabectome into practice for his colleagues at the American Glaucoma Society meeting.
The ideal patient has open-angle exfoliation glaucoma, he said.
“A clear view of angle structure is critical for any gonioscopic surgery,” Francis said.
Brian A. Francis
A high starting IOP is “nice,” he said, because these patients usually achieve significant pressure lowering into the mid-teens.
Trabectome (NeoMedix) is “probably not good in patients with normal tension glaucoma already starting in the mid-teens,” he said.
And, finally, patients with only mild to moderate glaucoma damage are ideal.
Francis said he tells patients that it is reasonable to expect a final IOP in the mid-teens.
“You’re just not going to get to the 10 mm Hg level consistently. The patient may need medications. But most importantly there’s an avoidance of devastating complications with these surgeries,” Francis said. “And the patient does have the opportunity to undergo more invasive surgery in the future because he has not compromised that conjunctival space.”
Disclosure: Francis is on the medical advisory board for NeoMedix and Endo Optiks and receives research support from AqueSys.