MIGS use increased twofold from 2013 to 2018
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The use of minimally invasive glaucoma surgery in the U.S. increased twofold, with a gradual decrease in the use of standard procedures, from 2013 to 2018, according to the IRIS Registry.
“There was a significant increase in MIGS use over the recent 6-year period despite limited evidence of their long-term safety or effectiveness, highlighting the need for studies comparing safety and outcomes of novel MIGS vs. traditional surgical treatments for glaucoma,” Shuang-An Yang, MD, MPH, said at the virtual American Glaucoma Society annual meeting.
Yang and colleagues used the American Academy of Ophthalmology IRIS Registry to measure the adjusted annual number of MIGS and standard surgical techniques, such as trabeculectomy or glaucoma drainage devices, performed in the U.S.
The researchers identified 7,586 MIGS procedures in 2013, which increased to 39,677 MIGS procedures in 2018, and a decrease in standard glaucoma procedures from 16,215 in 2013 to 13,701 in 2018.
The iStent (Glaukos) accounted for 43.7% of all glaucoma surgeries in the U.S. by 2017, according to data in the IRIS Registry.
The most common concurrent procedures in the study period were the iStent and endoscopic cyclophotocoagulation, accounting for 58.9% of all concurrent procedures, Yang said.
“This may not only be because of the additive benefits of combined procedures with different mechanistic action, but also the practical ease to be performed in combination. In addition, this trend may be driven by higher reimbursements for combined procedures,” she said.
Yang said white patients were more likely to receive the iStent or Xen gel stent (Allergan) when compared with younger and Black patients, who were more likely to receive trabeculectomy and glaucoma drainage devices.
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Yang S, et al. Trends and usage patterns of minimally invasive glaucoma surgery (MIGS) in the U.S. Presented at: American Glaucoma Society annual meeting; March 4-7, 2021 (virtual meeting).
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