The Aging Lens and Glaucoma in persons over 50: Why early cataract surgery/refractive lensectomy and microinvasive trabecular bypass can prevent blindness and cure elevated eye pressure

Abstract Minimally invasive glaucoma surgery (MIGS) has fulfilled an unmet need in the management of glaucoma. This chapter highlights some controversial issues regarding the use of MIGS in clinical practice, including (1) whether there is sufficient evidence to advocate combining MIGS with cataract surgery over cataract surgery alone, (2) the merits and drawbacks of different approaches to trabecular bypass and canal-based MIGS procedures, (3) the effect of MIGS on endothelial cell loss, (4) suprachoroidal MIGS devices and whether there is still a role for these procedures, and (5) a comparison between subconjunctival MIGS and trabeculectomy. Several questions are still left unanswered and hopefully, further research and more clinical experience with these new technologies will help improve surgical outcomes for patients.

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12-Month Retrospective Comparison of Kahook Dual Blade Excisional Goniotomy with Istent Trabecular Bypass Device Implantation in Glaucomatous Eyes at the Time of Cataract Surgery

Advances in Therapy ◽

10.1007/s12325-019-01025-1 ◽

2019 ◽

Vol 36 (9) ◽

pp. 2515-2527 ◽

Cited By ~ 12

Author(s):

Mohammed K. ElMallah ◽

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Leonard K. Seibold ◽

Malik Y. Kahook ◽

Blake K. Williamson ◽

...

Keyword(s):

Cataract Surgery ◽

Device Implantation ◽

Retrospective Comparison ◽

Trabecular Bypass ◽

Kahook Dual Blade

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Ocular Hypertension in Blacks

10.5772/intechopen.96606 ◽

2021 ◽

Author(s):

Daniel Laroche ◽

Kara Rickford

Keyword(s):

Cataract Surgery ◽

Ocular Hypertension ◽

Vision Loss ◽

Surgical Care ◽

Wealth Inequality ◽

Health Inequities ◽

Increased Risk ◽

Risk Patients ◽

Trabecular Bypass ◽

The Mean

Ocular hypertension occurs when intraocular pressure (IOP) is greater than the normal range with no evidence of vision loss or damage to the optic nerve. Individuals with ocular hypertension have an increased risk for glaucoma. The mean normal IOP is 15 mmHg and the mean IOP of untreated glaucoma is 18 mmHg. Elevated IOP commonly occurs in patients over the age of 50 and is often due to enlargement of the lens, narrowing of the angle, iridolenticular apposition, and pigment liberation that obstructs the trabecular meshwork. Cataract surgery and lensectomy can lower IOP and reduce the risk of glaucoma. The global wealth inequality of Blacks has created health inequities that have led to decreased access to surgical care contributing to higher rates of blindness from glaucoma. Greater education on the benefits of early cataract surgery and trabecular bypass for higher risk patients, as well as addressing wealth and health inequities, can help to bend the curve of blindness from glaucoma.

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