EyeWorld Asia-Pacific June 2011 Issue

39 June 2011 EW GLAUCOMA “If I have a patient in whom I am doing a cataract extraction and I want a little more pressure lowering then I will add an endolaser,” Dr. Rhee said. Trabeculectomy add-on Patients who receive a trabeculectomy may benefit from the addition of an EX-PRESS Glaucoma Filtration Device (Alcon, Fort Worth, Texas, USA/ Hünenberg, Switzerland). The transcleral procedure moves beyond traditional trabeculectomies by offering internal resistance to potentially reduce hypotony-related complications. “The disadvantage is that it is made of stainless steel so the long-term issues may be problematic,” Dr. Rhee said. “Also, there is an additional cost and the additional benefit is modest.” Ongoing research is expected to help further clarify which patients and conditions will most benefit from each of these procedures. However, none of them are expected to supplant trabeculectomy for all procedures. “Given the long- term complications of trabeculectomy and the high peri-operative complication rates in comparison to these new devices, we need to move away from this gold standard concept and start to adopt the concept of utilizing specific devices and procedures for the management of individual conditions, patients, and scenarios,” Dr. Rhee said. EW Editors’ note: Dr. Cantor was an investigator for Glaukos and iScience (Menlo Park, Calif., USA), and he has financial interests with Abbott Medical Optics (Santa Ana, Calif., USA). Dr. Lewis has financial interests with Alcon, AqueSys (Irvine, Calif., USA), Glaukos, iScience, Ivantis (Irvine, Calif., USA), and Transcend Medical (Menlo Park, Calif., USA). Dr. Rhee has no financial interests related to his comments. Contact information Cantor: 317-274-8485, lcantor@iupui.edu Lewis: 916-649-1515, rlewiseyemd@yahoo.com Rhee: 617-573-3670, douglas_rhee@meei.harvard.edu Now available eyeworld.org/blevent2011 Crystalens Breakfast Symposium from the 2011 ASCRS•ASOA Symposium and Congress Moderator: John A. Hovanesian, MD Faculty: Harvey Carter, MD Y. Ralph Chu, MD Steven J. Dell, MD Guy M. Kezirian, MD Jay S. Pepose, MD, PhD Robert J. Weinstock, MD Sponsored by