MIGS, cataract surgery combination benefits patients, surgeons
Click Here to Manage Email Alerts
WAILEA, Hawaii — Ophthalmologists should consider combining cataract surgery with conventional outflow minimally invasive glaucoma surgery when treating patients with glaucoma, according to a speaker here.
“Combo is the right thing to do,” Lorraine M. Provencher, MD, said in a prerecorded presentation at Hawaiian Eye 2024. “It reduces [a patient’s] field progression over time, and it leads to fewer secondary surgical interventions.”
Image: Adobe Stock
Provencher said that, when possible, she prefers combining cataract surgery and conventional outflow MIGS rather than cataract surgery and bleb-forming surgery due to higher failure rates.
“There’s a role for it, but it’s harder to combine cataract surgery with a bleb-forming surgery,” she said. “And if you add in yet another risk factor for failure, like age or if they are of African descent, you’re either going to have to think about really going up on your mitomycin, or at that point, I will consider switching to something like a tube implant. It’s going to be a little more resistant to fibrosis.”
In contrast, combining phaco with MIGS is a quick, safe option that maintains and improves a patient’s physiological outflow pathways, according to Provencher. In addition, the combination procedure offers quality of life improvements for patients, including faster visual recovery and fewer postop IOP spikes.
Provencher said there is a growing amount of longer-term durability data for the combination procedure, supporting the need for fewer medications and secondary interventions, with less diurnal fluctuation and visual field loss over time.
“I’m all about doing things to make my life easier and to make my patient’s life easier. I love for that reason combining cataract surgery with a conventional outflow MIGS,” she said. “It’s safe, it’s quick, it’s good for patients, and it’s good for surgeons.”
Collapse
Provencher L. The management of coincident cataract and glaucoma: Give me 5! Presented at: Hawaiian Eye 2024; Jan. 13-19, 2024; Wailea, Hawaii.
Read more about
Click Here to Manage Email Alerts