• Glaucoma Procedure Preferences: When Surgeons Adopt the Patient Role

    Written By: Lynda Seminara
    Selected By: Deepak P. Edward, MD

    Journal Highlights

    Eye
    2019;33(10):1577-1583

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    If you were the patient, which glaucoma procedure would you prefer? Chang et al. surveyed the members of the Amer­ican Glaucoma Society (AGS) to deter­mine which glaucoma procedure they would prefer to have performed on themselves and then compared results with those of a previous AGS survey on practice preferences for hypothetical patient vignettes.

    For the present study, the authors distributed a survey electronically to AGS members, who completed it anonymously. Participants were asked to adopt the role of a patient who had open-angle glaucoma and progressive visual field loss requiring surgery. Three pre-op intraocular pressure (IOP) sce­narios were given (<21, 21-26, and >26 mm Hg), and respondents were asked to choose the glaucoma procedure(s) they would prefer to receive for each IOP scenario.

    Overall, 289 surgeons participat­ed (27.4% of active/provisional AGS members). The most preferred proce­dures, for the three IOP ranges com­bined, were ab interno trabeculotomy (20.3%), Xen gel stent (18.6%), iStent with two devices (14.3%), and tradi­tional trabeculectomy plus mitomycin C (14.1%). A significant number of participants would prefer procedures that spared the conjunctiva or did not result in bleb formation, even for the lowest pre-op IOP level. For all three IOP ranges, older surgeons were more likely than their younger counterparts to prefer traditional trabeculectomy and to have just one procedure.

    The original article can be found here.