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A new mindset for interventional glaucoma

Dr Ike Ahmed calls for a long-term strategy of blindness prevention at SECO 2019

29 Mar 2019 by John White

“We are seeing evolutionary change in glaucoma management – coupled with revolutionary change.”

So explained world renowned ophthalmologist Dr Ike Ahmed, recognised for his ground-breaking work in the diagnosis and surgical treatment of eye diseases including glaucoma, in his presentation, Interventional glaucoma: the future is now and present at SECO 2019, New Orleans (20–24 February).

The surgeon challenged the audience to consider: “Why do people still go blind from glaucoma?,” adding that treatments options available have not been patient-centric enough.

Introducing the theme of “being different” in his lecture, the ophthalmologist told students in attendance to “challenge your teachers’ thinking – our current paradigm is not working.”

Dr Ahmed highlighted that “most of us in the profession adopt a watch and wait approach” towards using surgical interventions for patients but cautioned that he now believed this created a “false sense of security.”

“It is a terrible way to think. Why are we waiting to operate? We are scared. I understand that, but we need to change,” he said.

The profession should, he added, consider surgery as a first-line option, pointing to the latest developments with advanced microsurgical devices and techniques in glaucoma surgery, adding that “it is important for patients that surgery is not invasive.”

Reflecting on the use of minimally invasive glaucoma surgery (MIGS), Dr Ahmed told delegates that “it is a myth that MIGs replace trabeculotomy surgery for glaucoma patients.”

“It is not a fair comparison” he explained, adding: “In fact the procedures should be complementary.”

Looking to the future, Dr Ahmed called for “a new mindset” in interventional glaucoma. This meant adopting a proactive approach, using MIGS and novel glaucoma drainage devices, and exploring “sustained release drug delivery and MIGS synergy to address adherence,” he said.

“Every patient with glaucoma deserves the right to see to live and to live to see,” Dr Ahmed explained. “We need a long-term strategy of blindness prevention.”

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