Medical therapy is the first treatment choice for most patients with glaucoma; however, in a relevant proportion of patients, intraocular pressure (IOP) reduction is achieved with multi-therapy and/or high therapeutic doses. Conventional surgery is the standard alternative to medical therapy when this is not effective or not tolerated. Recently, selective laser trabeculoplasty (SLT) has been advocated as first-line therapy, and “minimally invasive glaucoma surgery” (MIGS) has been developed as safer and less traumatic surgical intervention for patients with glaucoma. Schlemm’s canal surgery has emerged as one of the approaches with the most favorable risk-benefit profile for glaucoma patients in need of cataract surgery. However, despite the promising results, use of MIGS in Italy has been extremely low. We aimed to investigate the reasons of the lower-than-expected use of Schlemm’s canal-based MIGS devices in Italy, share our perspective on their potential place in therapy, and give practical suggestions to improve the management of glaucoma patients.

Minimally invasive surgery in mild-to-moderate glaucoma patients in italy: Is it time to change?

Fea A. M.
2020

Abstract

Medical therapy is the first treatment choice for most patients with glaucoma; however, in a relevant proportion of patients, intraocular pressure (IOP) reduction is achieved with multi-therapy and/or high therapeutic doses. Conventional surgery is the standard alternative to medical therapy when this is not effective or not tolerated. Recently, selective laser trabeculoplasty (SLT) has been advocated as first-line therapy, and “minimally invasive glaucoma surgery” (MIGS) has been developed as safer and less traumatic surgical intervention for patients with glaucoma. Schlemm’s canal surgery has emerged as one of the approaches with the most favorable risk-benefit profile for glaucoma patients in need of cataract surgery. However, despite the promising results, use of MIGS in Italy has been extremely low. We aimed to investigate the reasons of the lower-than-expected use of Schlemm’s canal-based MIGS devices in Italy, share our perspective on their potential place in therapy, and give practical suggestions to improve the management of glaucoma patients.
CLINICAL OPHTHALMOLOGY
14
-
2639
2655
Cataract surgery; Glaucoma; IOP reduction; Minimally invasive surgery; Trabecular bypass
Costagliola C.; Sbordone M.; Gandolfi S.; Cesari L.; Furneri G.; Fea A.M.
File in questo prodotto:
File Dimensione Formato  
opth-264839-minimally-invasive-surgery-in-mild-to-moderate-glaucoma-pati.pdf

accesso aperto

Tipo di file: PDF EDITORIALE
Dimensione 2.47 MB
Formato Adobe PDF
2.47 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1798682
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact