Demographic and Clinical Characteristics Associated with Minimally Invasive Glaucoma Surgery Use

Olivier, Mildred M.G.; Smith, Oliver J.; Croteau-Chonka, Clarisse C.; VanderBeek, Brian L.; Maguire, Maureen G.; Lum, Flora; Fujino, Danielle; Kelly, Scott P.; Rich, William L.; Miller-Ellis, Eydie

doi:10.1016/j.ophtha.2021.02.012

Cited by 26 publications

(15 citation statements)

References 18 publications

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“…In contrast, Tam et al found that women had higher eye screening failure rates. Women were less likely to undergo certain ophthalmic surgical procedures . In contrast, 11 studies found no association between sex and/or gender and ophthalmic conditions, follow-up adherence, or access to eye care .…”

Section: Resultsmentioning

confidence: 93%

Inequities and Research Gaps in Ophthalmology

et al. 2023

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ImportanceDeficient ophthalmologic care is costly to patients, making the identification of groups not receiving adequate care of vital importance. The current landscape of equity in ophthalmic care has yet to be thoroughly investigated and is important to ensure inclusivity and patient-centered care.ObjectiveTo perform a scoping review of the literature pertaining to health care inequities in the field of ophthalmology.Evidence ReviewA comprehensive database search using MEDLINE (via PubMed) and Ovid Embase was done in July 2022. English-language articles published from 2016 to 2021 were included and encompassed all article types except commentaries or correspondence. The search modeled the National Institutes of Health list of designated US health inequity populations, which includes income, education level, occupational status, rural and underresourced area, sex and gender, lesbian, gay, bisexual, transgender, and queer (LGBTQ) identity, and race and ethnicity. A total of 8170 abstracts and titles were screened by 2 independent investigators, and 189 studies were assessed in full text for eligibility. For inclusion, articles needed to be an ophthalmic study discussing health inequities. In a masked, duplicate fashion, 2 independent investigators screened 75 full-text studies for data extraction using a pilot-tested form. Data extraction included general publication characteristics and health inequity data based on the National Institutes of Health’s defined inequity groups.FindingsA total of 75 publications were included. Notable inequities were found among Black and Hispanic patients associated with negative ophthalmic outcomes and mixed associations regarding sex or gender. Overall, lower-income patients were more likely to have vision impairment, use eye care services less, and have lower adherence to eye examinations. No articles within our sample examined LGBTQ inequities among ophthalmology patients since the 2016 National Institutes of Health classification of sexual and gender minority populations. Substantial research gaps were observed within the ophthalmic literature pertaining to the LGBTQ community, race and ethnicity, and rural and underresourced areas.Conclusions and RelevanceThis scoping review found substantial findings associated with the LGBTQ community, race and ethnicity, and the role of telemedicine in rural and underresourced areas. Because of the importance of ophthalmic care in overall patient health, it is vital to understand the various inequities present and strive to improve the current gaps in the literature. Future studies should (1) examine barriers to clinical study and medical trainee recruitment as well as patient values and preference studies and (2) investigate the implementation of telemedicine in underresourced areas.

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Section: Resultsmentioning

confidence: 93%

Inequities and Research Gaps in Ophthalmology

et al. 2023

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“…Increasing the complexity of drop therapy is also known to decrease patient adherence [ 15 , 16 ], which could contribute to the diminishing overall effectiveness, and increase undesirable effects on the ocular surface [ 17 ]. Alternatively, MIGS, particularly when there is comorbid cataract, is increasingly being utilized in mild to moderate glaucoma for patients inadequately controlled on IOP-lowering drops, or where there may be tolerance or adherence issues [ 1 , 2 ]. TBS devices are frequently used as a first MIGS procedure perhaps in part due to ease of device use and a desire to minimally disrupt or alter outflow anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive glaucoma surgery (MIGS) has changed the treatment of mild to moderate open-angle glaucoma dramatically over a relatively short span of time [ 1 , 2 ]. The favorable safety profile, particularly in conjunction with cataract surgery, has resulted in a shift to surgical intervention in earlier disease, with the goal of delaying or obviating the need for traditional filtration surgery [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Canaloplasty and trabeculotomy with the OMNI® surgical system in OAG with prior trabecular microbypass stenting

Terveen

Sarkisian

Vold³

et al. 2022

Int Ophthalmol

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Purpose Evaluate effectiveness and safety outcomes for patients treated with canaloplasty and trabeculotomy previously treated with a trabecular microbypass stent (TBS). Methods Retrospective, multicenter, IRB approved study. Patients treated with TBS (iStent/iStent inject, Glaukos) and subsequently with OMNI surgical system (OSS) (Sight Sciences). From 5 practices in 5 US states. Open-angle glaucoma (OAG), minimum 3 months follow-up after OSS surgery, Pre-OSS IOP ≥ 17 mmHg on ≥ 1 medication. No glaucoma procedures between TBS and OSS. Endpoints: proportion with ≥ 20% reduction in IOP, IOP between 6 and 18 mmHg, mean IOP, change in IOP, mean number of medications. Adverse events and secondary surgical interventions (SSI). Mann–Whitney rank sum test compared pre-OSS IOP and medications with follow-up. Results Twenty seven patients. Average age (SD) 72.2 (10.8), 22/27 primary OAG (82%), mean MD − 6.2 (7.0) dB. Mean IOP before OSS 22.3 (4.3) mmHg on 2.2 (1.3) medications. At last follow-up (mean 11 months) IOP was 17.2 mmHg on 1.8 medications, − 5.1 mmHg (− 23%, p < .001), − 0.4 meds (− 18%, p = .193); ≥ 20% IOP reduction (41%), IOP ≤ 18 (56%). Adverse events were non-serious. Hyphema > 1 mm (3, 11%), BCVA decrease (4, 15%), IOP spike (2, 7%). SSI (4, 15%) had higher pre-OSS IOP (23.4 mmHg) and worse MD (− 9.6 dB). Conclusion Patients uncontrolled by medication and a prior TBS would once have been candidates for trabeculectomy and tube shunts. OSS offered a minimally invasive option that provided IOP control and avoidance of traditional surgery for the majority over follow-up averaging 11 months and up to 42 months.

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“…Although recent years have welcomed a wave of foundational leaders in ophthalmologic public health, the use of GIS in ophthalmologic epidemiology has been rather limited in the United States. Most seminal observational studies [31,32] and the newer IRIS Registry data [5,33,34] are limited to a single locale, provide no geographic detail, or report on the four US census regions [35]. In some cases, patient privacy safeguards limit the geographic information contained in the data [36].…”

Section: Gis Analysis Softwarementioning

confidence: 99%

The evolving field of Big Data: understanding geographic information systems analysis and its transformative potential in ophthalmic research

Soares¹

2022

Current Opinion in Ophthalmology

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Purpose of reviewThe purpose of this review to is to highlight alternative uses of Big Data in the pursuit of ophthalmologic public health. In particular, we highlight geographic information systems (GIS) analysis as a type of Big Data, summarize various GIS methods, and enumerate sources of geographic data. Recent findingsThe recent implementation of the IRIS Registry Data, has expanded our real-world knowledge of ophthalmology in the United States. Such innovations in Big Data allow us to better define ophthalmic diseases, treatments, and outcomes for underserved individuals and subpopulations. One underutilized source of Big Data entails use of geographic information to evaluate geographic heterogeneity and access across the United States. SummaryGIS and Big Data allow for refined epidemiologic estimates of eye disease for specific communities. In particular, how GIS can enable researchers to examine disparities in access to ophthalmic care is reviewed. GIS best practices and some data sources for GIS in ophthalmology are also summarized.

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Demographic and Clinical Characteristics Associated with Minimally Invasive Glaucoma Surgery Use

Cited by 26 publications

References 18 publications

Inequities and Research Gaps in Ophthalmology

Inequities and Research Gaps in Ophthalmology

Canaloplasty and trabeculotomy with the OMNI® surgical system in OAG with prior trabecular microbypass stenting

The evolving field of Big Data: understanding geographic information systems analysis and its transformative potential in ophthalmic research

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