MINIMALLY INVASIVE GLAUCOMA SURGERY

Course overview

GLAUCOMA IS A CHRONIC PROGRESSIVE OCULAR PATHOLOGY THAT AFFECTS THE OPTIC NERVE AND RESULTS IN IRREVERSIBLE VISION LOSS. THE CONDITION IS ALSO CALLED THE SILENT THIEF OF SIGHT, AS IT SLOWLY DAMAGES THE OPTIC NERVE BEFORE ANY NOTICEABLE CENTRAL VISION LOSS CAN OCCUR. THE DAMAGE IS DUE TO PERSISTENTLY RAISED INTRAOCULAR PRESSURE (IOP), WHICH DAMAGES THE OPTIC NERVE AND CAUSES VISUAL FIELD DEFECTS. THE MEDICAL MANAGEMENT OF GLAUCOMA IS BY EITHER TOPICAL ANTIGLAUCOMA MEDICATIONS, LASER PERIPHERAL IRIDOTOMY, OR LASER TRABECULOPLASTY TO LOWER THE IOP. THE SURGICAL MANAGEMENT IS IN THE FORM OF TRABECULOPLASTY OR GLAUCOMA DRAINAGE DEVICES. THE SURGICAL MANAGEMENT OPTIONS ARE ASSOCIATED WITH MANY INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS, REQUIRE LONG-TERM FOLLOW-UP, AND MAY HAVE PROLONGED RECOVERY TIME. THE SURGICAL MANAGEMENT OPTIONS ARE INDICATED FOR SEVERE DISEASES WHEN MEDICAL MANAGEMENT FAILS. OVER THE YEARS, THERE HAVE BEEN LIMITED OPTIONS FOR MILD-TO-MODERATE ILLNESS PATIENTS WITH UNCONTROLLED IOP. TO FILL THIS GAP, NOVEL MICROINVASIVE OR MINIMALLY INVASIVE GLAUCOMA SURGERY (MIGS) HAS BEEN INTRODUCED. PATIENTS WITH MILD-TO-MODERATE GLAUCOMA WHO ARE NONCOMPLIANT OR INTOLERANT TO TOPICAL DRUGS ARE IDEAL CASES FOR MIGS. THE MIGS IMPLANT CAN BE IMPLANTED DURING PHACOEMULSIFICATION SURGERY, REDUCING DEPENDENCE ON TOPICAL MEDICATIONS. THIS ACTIVITY HIGHLIGHTS THE INDICATIONS, CONTRAINDICATIONS, CLASSIFICATION, TECHNIQUE, COMPLICATIONS, AND CLINICAL SIGNIFICANCE OF PERFORMING MIGS BY AN INTERPROFESSIONAL TEAM.