EyeWorld Asia-Pacific December 2019 Issue

Pathways to Success Interactive Discussions for Personalized Glaucoma Care ( t the 32nd APACRS annual meeting in Kyoto, Japan, EyeWorld Asia- Pacific hosted a lunch symposium consisting of an informal panel discussion, moderated by Ron- ald Yeoh, MD, to lead the way for successful clinical outcomes for glaucoma patients. David Lubeck, MD, began the discussion focusing on using minimally invasive glaucoma surgery (MIGS) to treat the side effects of glaucoma medications. Highlighting the significant im- pact MIGS has had on his time as a surgeon, Dr. Lubeck said, “After being a cataract surgeon for 25 years, MIGS was the most enjoyable new procedure, and it’s made me a better surgeon overall, so I appreciate it not just for what it is for glaucoma patients, but what it’s done for me as a surgeon with my capa- bilities.” In one case of a 67-year-old male, the patient presented with arcuate defect consistent with nerve fiber loss and had previ- ously underwent primary selec- tive laser trabeculoplasty (SLT). This patient’s IOP post-SLT on no medications was stable after the procedure was completed in 2016. Dr. Lubek proposed that the patient will likely undergo cataract surgery with MIGS in the next 1 to 2 years, and if IOP is inadequately controlled after MIGS, the patient may repeat the SLT procedure. Dr. Lubeck continued to say that in 2016, SLT was not a chosen modality for most glaucoma specialists, but the LiGHT trial in 2018 showed that SLT has equal effi- cacy compared to medication as first line therapy. Robert Ang, MD, presented a case of a 29-year-old female who was consulted for refractive surgery. In this long and diffi- cult case, the patient underwent implantation of ICL. However, postoperative IOP measure- ments continually increased even though the patient was put on many IOP-lowering medications. After ICL explan- tation and canaloplasty Dr. Ang stated that her IOP continued to remain very high while being on a maximum number of medications. Then, after eleven long months, Dr. Ang performed SLT, and the patient was finally Copyright 2019 APACRS. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or publisher, and in no way imply endorsement by EyeWorld, Asia-Pacific or APACRS. “ After being a cataract surgeon for 25 years, MIGS was the most enjoyable new procedure, and it’s made me a better surgeon overall, so I appreciate it not just for what it is for glaucoma patients, but what it’s done for me as a surgeon with my capabilities. ” David Lubeck, MD Supported by unrestricted educational grants from Glaukos, EyeWorld Asia-Pacific, and APACRS. Ronald Yeoh, MD Moderator David Lubeck, MD Panel Robert Ang, MD Panel Florian Kretz, MD Panel