terms of the percentage of
patients who receive glau-
coma treatment during
cataract surgery," says Dr.
Williamson. "That needs
to change."
He believes cataract surgeons should inform their patients of the
benefits of combining the procedures. "Offering patients the option of
lowering intraocular pressure while we're inside the eye should be the
standard of care," he says.
He also points out that surgeons need to be more active and aggres-
sive in treating glaucoma in pseudophakic patients, adding "There are
more devices entering the market for that indication."
An increasing number of surgeons are implanting stents labeled for
use during cataract surgery in standalone glaucoma procedures, points
out Dr. Sarkisian. "Just because they were approved for use during
cataract surgery doesn't mean that's the best way to use them," he says
of the off-label application that's effectively reducing IOP.
Expected growth
Unfortunately, 5-year outcomes data for most glaucoma surgical treat-
ments are poor — 50% of the interventions fail, according to Dr.
Lewis. Experts are therefore looking for ways to improve interven-
tional glaucoma.
"What we need, frankly, is data showing how to optimize care for
individual patients with specific procedures," adds Dr. Soohoo, "but
that type of data doesn't exist."
But as more surgeons adopt the mindset of interventional glauco-
ma specialists — treating patients with mild to moderate forms of
the disease before they suffer structural or functional damage in the
F E B R U A R Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 2 7
Offering patients the option of
lower intraocular pressure while
we're already inside the eye should
be the standard of care.
— Blake Williamson, MD
