Glaucoma Awareness

Nathan M. Radcliffe, MD

Radcliffe reports consulting for Alcon, Allergan, Glaukos, Iantrek, and New world Medical.


January 02, 2025
2 min watch
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VIDEO: Strong data drive advances in glaucoma field

Transcript

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We have a lot of new technology to offer patients these days, and fortunately, all of this really comes on the heels of really good datasets and well-conducted studies. You know, when we look at the pyramid of the quality of evidence, the prospective multicenter randomized trial is really the way to get data that shows that one therapy is, you know, the way to go, or at least to best understand its safety and efficacy.

We have that with laser. We have that with many of the MIG stents and even some of the new approaches. You know, the bio-interventional glaucoma surgery is new, but I'm happy to see that we already have good, you know, intermediate, long-term safety data, good efficacy data with large numbers of patients. It's important for a number of reasons. The most important, of course, is so that we can educate ourselves and our patients on what the safety and efficacy is, so we can tell them what they can expect from a procedure. It's also important in a more realistic manner for insurers.

In fact, we just went through some big challenges where Medicare was threatening not to pay for, for example, a goniotomy. But, you know, one of the companies that has a goniotomy procedure bought ahead on this one, and they did a prospective randomized multi-center trial comparing goniotomy with, let's say the Kahook Dual Blade versus a trabecular bypass stent, and they showed that they had equivalent efficacy. We, from a policy level, we're able to argue with Medicare that this shows that the procedure should enjoy the same coverage as the stents.

I feel like our field is growing up, we're recognizing the value of quality data, be it laser trabeculoplasty or some of the MIGS procedures or some of even the newer procedures.This strengthens the field as a whole and improves the quality of our care, and it allows us to defend the procedures we offer, both to ourselves, to our patients, and in some cases, to the insurers.