Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?

Ciro Costagliola,1 Mario Sbordone,2 Stefano Gandolfi,3 Luca Cesari,4 Gianluca Furneri,5 Antonio Maria Fea6 1Department of Medicine & Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy; 2Ophthalmology Unit, Santa Maria Delle Grazie Hospital, Pozzuoli, Na...

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Autores principales:	Costagliola C, Sbordone M, Gandolfi S, Cesari L, Furneri G, Fea AM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	minimally invasive surgery glaucoma iop reduction trabecular bypass cataract surgery. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/35d86f134ea644d58337d892e7012233
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spelling	oai:doaj.org-article:35d86f134ea644d58337d892e70122332021-12-02T15:41:48ZMinimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?1177-5483https://doaj.org/article/35d86f134ea644d58337d892e70122332020-09-01T00:00:00Zhttps://www.dovepress.com/minimally-invasive-surgery-in-mild-to-moderate-glaucoma-patients-in-it-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ciro Costagliola,1 Mario Sbordone,2 Stefano Gandolfi,3 Luca Cesari,4 Gianluca Furneri,5 Antonio Maria Fea6 1Department of Medicine & Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy; 2Ophthalmology Unit, Santa Maria Delle Grazie Hospital, Pozzuoli, Naples, Italy; 3Ophthalmology Unit, Department of Biological, Biotechnological and Translational Sciences, University of Parma, Parma, Italy; 4UOC Ophthalmology - Area 5, Ascoli Piceno, San Benedetto del Tronto, Italy; 5EBMA Consulting SRL, Melegnano, Milan, Italy; 6Department of Surgical Sciences, University of Turin, Turin, ItalyCorrespondence: Gianluca FurneriEBMA Consulting SRL, Via per Carpiano, 2 – 20077, Melegnano, MI ItalyEmail gianluca.furneri@ebmaconsulting.comAbstract: Medical therapy is the first treatment choice for most patients with glaucoma; however, in a relevant proportion of patients, intraocular pressure (IOP) reduction is achieved with multi-therapy and/or high therapeutic doses. Conventional surgery is the standard alternative to medical therapy when this is not effective or not tolerated. Recently, selective laser trabeculoplasty (SLT) has been advocated as first-line therapy, and “minimally invasive glaucoma surgery” (MIGS) has been developed as safer and less traumatic surgical intervention for patients with glaucoma. Schlemm’s canal surgery has emerged as one of the approaches with the most favorable risk-benefit profile for glaucoma patients in need of cataract surgery. However, despite the promising results, use of MIGS in Italy has been extremely low. We aimed to investigate the reasons of the lower-than-expected use of Schlemm’s canal-based MIGS devices in Italy, share our perspective on their potential place in therapy, and give practical suggestions to improve the management of glaucoma patients.Keywords: minimally invasive surgery, glaucoma, IOP reduction, trabecular bypass, cataract surgeryCostagliola CSbordone MGandolfi SCesari LFurneri GFea AMDove Medical Pressarticleminimally invasive surgeryglaucomaiop reductiontrabecular bypasscataract surgery.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2639-2655 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	minimally invasive surgery glaucoma iop reduction trabecular bypass cataract surgery. Ophthalmology RE1-994
spellingShingle	minimally invasive surgery glaucoma iop reduction trabecular bypass cataract surgery. Ophthalmology RE1-994 Costagliola C Sbordone M Gandolfi S Cesari L Furneri G Fea AM Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?
description	Ciro Costagliola,1 Mario Sbordone,2 Stefano Gandolfi,3 Luca Cesari,4 Gianluca Furneri,5 Antonio Maria Fea6 1Department of Medicine & Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy; 2Ophthalmology Unit, Santa Maria Delle Grazie Hospital, Pozzuoli, Naples, Italy; 3Ophthalmology Unit, Department of Biological, Biotechnological and Translational Sciences, University of Parma, Parma, Italy; 4UOC Ophthalmology - Area 5, Ascoli Piceno, San Benedetto del Tronto, Italy; 5EBMA Consulting SRL, Melegnano, Milan, Italy; 6Department of Surgical Sciences, University of Turin, Turin, ItalyCorrespondence: Gianluca FurneriEBMA Consulting SRL, Via per Carpiano, 2 – 20077, Melegnano, MI ItalyEmail gianluca.furneri@ebmaconsulting.comAbstract: Medical therapy is the first treatment choice for most patients with glaucoma; however, in a relevant proportion of patients, intraocular pressure (IOP) reduction is achieved with multi-therapy and/or high therapeutic doses. Conventional surgery is the standard alternative to medical therapy when this is not effective or not tolerated. Recently, selective laser trabeculoplasty (SLT) has been advocated as first-line therapy, and “minimally invasive glaucoma surgery” (MIGS) has been developed as safer and less traumatic surgical intervention for patients with glaucoma. Schlemm’s canal surgery has emerged as one of the approaches with the most favorable risk-benefit profile for glaucoma patients in need of cataract surgery. However, despite the promising results, use of MIGS in Italy has been extremely low. We aimed to investigate the reasons of the lower-than-expected use of Schlemm’s canal-based MIGS devices in Italy, share our perspective on their potential place in therapy, and give practical suggestions to improve the management of glaucoma patients.Keywords: minimally invasive surgery, glaucoma, IOP reduction, trabecular bypass, cataract surgery
format	article
author	Costagliola C Sbordone M Gandolfi S Cesari L Furneri G Fea AM
author_facet	Costagliola C Sbordone M Gandolfi S Cesari L Furneri G Fea AM
author_sort	Costagliola C
title	Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?
title_short	Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?
title_full	Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?
title_fullStr	Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?
title_full_unstemmed	Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?
title_sort	minimally invasive surgery in mild-to-moderate glaucoma patients in italy: is it time to change?
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/35d86f134ea644d58337d892e7012233
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Minimally Invasive Surgery in Mild-to-Moderate Glaucoma Patients in Italy: Is It Time to Change?

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