CURRENT CHALLENGE: PREDICTABLY ACHIEVING LOW TARGET IOP WITH A BETTER SAFETY PROFILE1
Hear it from your peers
Current glaucoma surgery methods can be effective, but variability of results remains an issue.2-4
What is your experience?
Answer a question and see how your response matches up with your peers’
MIGS has not yet shown the efficacy to reach low target IOP similar to that of trabeculectomy3,5-8
- MIGS is considered safe and efficient but has yet to harness the full IOP-lowering potential of the subconjunctival space to consistently reach low target IOP and reduce medication load like trabeculectomy.3,5-8
- There are no comparative data demonstrating that an ab externo MIGS via the subconjunctival approach can predictably achieve lower target IOP like trabeculectomy.7,9
*Not a head-to-head comparison. Based on findings from the TVT Study and the COMPARE Study.5,8
†Based on findings from the TVT Study.9
‡Based on follow-up time and the criteria used to define successful outcomes.10
Trabeculectomy success rates can be as low as 47% in 5 years.10,†
Intensive post-op follow-up is frequently necessary following trabeculectomy4,11
Up to 1 year following trabeculectomy11
63% of patients required post-op interventions
- These included bleb interventions such as laser suture lysis (29%), 5‑fluorouracil injection (21%), removal of releasable suture (18%), and needling (14%)
- A total of 6% of patients required re-operation to manage post-op complications
§Based on findings from Gedde 2018.11
A minimally invasive device that can reach target IOP approaching that of trabeculectomy but with more-predictable post-op is needed to empower proactive surgery.
References: 1. Amoozgar B, Wei X, Lee JH, et al. A novel flexible microfluidic meshwork to reduce fibrosis in glaucoma surgery. PLoS One. 2017;12(3):e0172556. 2. Nilforushan N, Yadgari M, Astaraki A, Miraftabi A. Comparison of the long-term outcomes of resident versus attending performed trabeculectomy. J Current Ophthalmol. 2017;29:169-174. 3. Bloom P, Au L. “Minimally invasive glaucoma surgery (MIGS) is a poor substitute for trabeculectomy”—the great debate. Ophthalmol Ther. 2018;7(2):203-210. 4. King AJ, Rotchford AP, Alwitry A, Moodie J. Frequency of bleb manipulations after trabeculectomy surgery. Br J Ophthalmol. 2007;91(7):873-877. 5. Ahmed IIK, Fea A, Au L, et al. A prospective randomized trial comparing Hydrus and iStent microinvasive glaucoma surgery implants for standalone treatment of open-angle glaucoma: the COMPARE Study [published online ahead of print April 26, 2019]. Ophthalmology. doi:10.1016/j.ophtha.2019. 6. Ayyala RS, Jewelewicz D, Bottorff J, De La Rosa S, Al-Dujali L, Morgan MG. Xen Gel Stent early results: safety and efficacy in the short term. Paper presented at: American Glaucoma Society Annual Meeting; February 28 to March 4, 2018; New York, NY. 7. Agrawal P, Bradshaw SE. Systematic literature review of clinical and economic outcomes of micro-invasive glaucoma surgery (MIGS) in primary open-angle glaucoma. Ophthalmol Ther. 2018;7(1):49-73. 8. Gedde SJ, Schiffman JC, Feuer WJ, et al; Tube Versus Trabeculectomy Study Group. Treatment outcomes in the Tube Versus Trabeculectomy (TVT) Study after five years of follow-up. Am J Ophthalmol. 2012;153(5):789-803.e2. 9. Lee RMH, Bouremel Y, Eames I, Brocchini S, Kaw PT. The implications of an ab interno versus ab externo surgical approach on outflow resistance of a subconjunctival drainage device for intraocular pressure control. Transl Vis Sci Technol. 2019;8(3):58. 10. Bhatia J. Outcome of trabeculectomy surgery in primary open angle glaucoma. Oman Med J. 2008;23(2):86-89. 11. Gedde SJ, Feuer WJ, Shi W, et al; Primary Tube Versus Trabeculectomy Study Group. Treatment outcomes in the primary Tube Versus Trabeculectomy Study after 1 year of follow-up. Ophthalmology. 2018;125(5):650-663.