EGS Glaucoma Surgery Course - Keithbarton.net

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EGS Glaucoma Surgery Course. Keith Barton. Nitin Anand. Tarek Shaarawy. Sheng Lim. ESCRS, Berlin, Monday 15 th. September 2008. Handout available ...
EGS Glaucoma Surgery Course Keith Barton Nitin Anand Tarek Shaarawy Sheng Lim

ESCRS, Berlin, Monday 15th September 2008 Handout available from: www.keithbarton.net Follow the link for ophthalmic professionals and look for ESCRS Berlin 2008. Password available on request by e-mail.

Glaucoma Surgery – Modern Perspectives

Nitin Anand Keith Barton Sheng Lim Tarek Shaarawy

Glaucoma Surgery – Modern Perspectives

Handout will be available in 2-3 days from: www.keithbarton.net Follow link “For Ophthalmic Professionals”

Evolution of Filtration Surgery

Deconstructing Trabeculectomy

Keith Barton Glaucoma Service Director Moorfields Eye Hospital London

Balance

Moorfields Primary Treatment Trial 1994

„ Filtration surgery is a continual trade off between efficacy and safety „ Moving from full thickness (Scheie’s-type) to guarded (Trabeculectomy) procedures improved safety but reduced success „ Nevertheless trabeculectomy remained more successful than medical treatment in the average patient

Surgical arm: no anti-proliferative drugs Medicine 19 15

Migdal et al. Ophthalmology 1994; 101: 1651 - 1656

Surgery

IOP achieved (mm Hg)

Target IOP and Recent Trials 45

No change

40

20% OHTS 25% EMGTS 30% CNTGS 36% CIGTS Meds

35 30 25

Lower pressure

44% CIGTS Trab

20 15

AGIS:

10