• Demographic and Clinical Features of MIGS Recipients

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, September 2021

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    Performing minimally invasive glau­coma surgery (MIGS) at the time of cataract extraction is becoming more routine. Understanding the demograph­ic and clinical profile of patients who undergo these procedures together may improve candidate selection for MIGS. In a retrospective review of data from the IRIS Registry, Olivier et al. gathered information on patients who had cata­ract surgery with or without MIGS and found links between MIGS use and var­ious features, including ethnicity, older age, higher cup-to-disc ratio (CDR), and moderate glaucoma severity.

    The study included adults who were 40 years old or older with a diagnosis of open-angle glaucoma (OAG) and no history of MIGS or cataract surgery who underwent cataract extraction, with or without concurrent MIGS, in the United States from 2013 through 2017. The authors applied multivariable logistic regression to determine odds ratios (ORs) and 95% confidence inter­vals (CIs) for variables of interest.

    Results showed that MIGS was more common in those older than 59 (OR, 1.10; 95% CI, 1.05-1.16), among Blacks (vs. Whites: OR, 1.11; 95% CI, 1.07-1.15), and in patients with Medicare (vs. private insurance: OR, 1.12; 95% CI, 1.10-1.15). Clinical features leading to MIGS use were moderate glaucoma as opposed to mild (OR, 1.07) and higher CDR (OR, 1.24 for CDR 0.5-0.8 vs. < 0.5; OR, 1.27 for CDR > 0.8-1.0 vs. < 0.5). MIGS frequency was higher in the Midwest and Northeast than in the South (OR, 1.32 and 1.26, respectively). It was lower among women (vs. men: OR, 0.96), patients taking five or more glau­coma medications (vs. one or two: OR, 0.94), and cases of severe glaucoma (vs. mild: OR, 0.64).

    These findings highlight the importance of capturing demographic and clinical factors in patients’ health records, said the authors, who believe such data clarify current practice patterns and inform future directions, including candidate selection for MIGS. They concluded that making appropri­ate changes to practice patterns “could broaden population access to a group of safer procedures that can address intraocular pressure and reduce the cost and adherence issues related to glaucoma medications.”

    The original article can be found here.