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O P H T H A L M O L O G Y
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or patients suffering from cataracts and glaucoma, treating both
conditions in a single surgery can deliver clinical advantages.
But does it make business sense for your surgical facility to
offer phaco and pressure relief as companion procedures? Read on to
consider what's at stake.
Dual solutions
In chronic, open-angle glaucoma, the most commonly diagnosed form,
intraocular pressure climbs gradually over time. In acute, angle-closure glaucoma, the blockage and pressure are sudden. Either way, the
solution is restoring the flow and reducing IOP. Eye surgeons have a
range of conventional and micro-incisional methods at their disposal
for accomplishing these goals.
Cataract surgery itself provides some relief in mild to moderate openangle cases. "When you take out the cataract, you get some glaucoma
control. It lowers IOP in and of itself," says Steven Dewey, MD, an ophthalmologist with Colorado Springs (Colo.) Health Partners. "But it
doesn't always give as much pressure reduction as you need. Cataract
surgery alone works for a limited time. Glaucoma is progressive. You
want your results to work for a long time."
Partnering cataract and glaucoma treatments, however, delivers
multiple benefits to the patient. "You get better IOP lowering, first of
all," says Steve Vold, MD, founder of Vold Vision in Fayetteville, Ark.
"You also get better vision. You remove the cloudy cataract, replace it
with a clear lens, correct the refractive error. This can be a pretty big
deal for a glaucoma patient," whose options may have been previously limited to IOP-lowering medicated eye drops and declining vision.
One company's mini-stent has only been indicated for use in
patients who are also undergoing cataract surgery. "Pivotal trials
showed that cataract surgery alone did a pretty good job at reducing
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