The shift towards interventional glaucoma (IG) – galvanized by the arrival of minimally invasive glaucoma surgery (MIGS) in the early 2000s – has gained increased traction in recent years, signalling a proactive approach that continues to be supported by a broad evidence base pointing to its benefits over more traditional methods of using topical medication as a first-line glaucoma therapy.
In response to this surging popularity in interventional procedures, a US-based team of researchers have sought to review the evidence in favour of this “IG revolution,” summarizing the consensus opinion of 10 glaucoma experts committed to IG principles. Their review led to the creation of a treatment protocol that can be used as a practical guide for surgeons “seeking to incorporate IG principles into their practices.”
“In the summer of 2024, a group of individuals sat in a conference room together to define what the treatment algorithm [for interventional glaucoma] looked like,” explains Deborah Ristvedt. “Think about getting a group of ophthalmologists, who are all passionate, and from rural to big cities around the US, and staying on track. It could have ended in too many opinions; yet collaboration and solution-based discussion led to [establishing this] protocol.”
The ten glaucoma specialists included Ristvedt and the three other authors of the study – Arkadiy Yadgarov, Christine M. Funke, and J. Morgan Micheletti – plus six other recognized experts in the field. At this conference, the group offered up their opinions on preferred treatment protocols at each stage of the disease (i.e. ocular hypertension, mild, moderate, and severe).
“Dissenting opinions were sought and submitted at every step of every severity level,” the study notes, until “unanimous consensus was achieved for all steps.” These varying steps were then collated into a treatment protocol (see below).
“[This is] an incredible opportunity to treat our glaucoma patients better than ever, in a safe and effective way,” says Ristvedt. “I cannot wait to continue to be involved in this wonderful journey.”
