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Success of phaco inspires development of MIGS

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LOS ANGELES — With increased investment and competition, the impact of surgical treatments for glaucoma is on the rise, according to a speaker here.

“By any measure, the impact of glaucoma surgery is increasing,” Reay H. Brown, MD, said at the American Society of Cataract and Refractive Surgery meeting. “We’ve always had the unmet need, but now we have the key ingredients of investment, dollars and competition.”

Reay H. Brown

Brown, who with his wife and colleague Mary G. Lynch, MD, has spent decades innovating in the microinvasive glaucoma surgery (MIGS) space, delivered the Charles D. Kelman, MD, Innovator’s Lecture.

Over the past 5 years, the FDA has approved three MIGS devices, each with a different mechanism: the Glaukos iStent, Alcon CyPass and Allergan Xen. More tools and devices are on the horizon, and the glaucoma surgery market value has sharply increased in response, into the billions of dollars, Brown said.

Brown likened the development of MIGS tools and techniques to the innovation of phacoemulsification.

“There’s no question that MIGS is changing the glaucoma treatment paradigm — more surgery, earlier surgery. MIGS, like phaco, looks obvious in retrospect but took years for development, years for acceptance,” Brown said. “Dr. Kelman is still our inspiration. He led the small-incision revolution for cataract surgery and everything else, and has really solved cataract. MIGS has been more of a team sport, and glaucoma is definitely not solved. We need more innovation, but one of the finest things about MIGS is that it gives us hope for the future that one day we will solve glaucoma,” Brown said. – by Patricia Nale, ELS

Reference:

Brown RH. Overcoming resistance: making glaucoma a surgical disease. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 5-9, 2017; Los Angeles.

Disclosure: Reay reports he has worked with Alcon, Transcend, Ivantis and Sight Sciences but has no active contracts with any MIGS companies.