Clinical Ophthalmology (Dec 2023)
Alternatives to Topical Glaucoma Medication for Glaucoma Management
Abstract
Sahar Bedrood,1 John Berdahl,2 Arsham Sheybani,3,4 Inder Paul Singh5 1Advanced Vision Care, Los Angeles, CA, USA; 2Vance Thompson Vision, Sioux Falls, SD, USA; 3John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 4Department of Ophthalmology and Visual Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; 5Eye Centers of Racine and Kenosha, Kenosha, WI, USACorrespondence: Sahar Bedrood, Advanced Vision Care, 2080 Century Park East Suite 911, Los Angeles, CA, 90067, USA, Tel +1 (310) 229-1220, Email [email protected]: Topical glaucoma medications have favorable safety and efficacy, but their use is limited by factors such as side effects, nonadherence, costs, ocular surface disease, intraocular pressure fluctuations, diminished quality of life, and the inherent difficulty of penetrating the corneal surface. Although traditionally these limitations have been accepted as an inevitable part of glaucoma treatment, a rapidly-evolving arena of minimally invasive surgical and laser interventions has initiated the beginnings of a reevaluation of the glaucoma treatment paradigm. This reevaluation encompasses an overall shift away from the reactive, topical-medication-first default and a shift toward earlier intervention with laser or surgical therapies such as selective laser trabeculoplasty, sustained-release drug delivery, and micro-invasive glaucoma surgery. Aside from favorable safety, these interventions may have clinically important attributes such as consistent IOP control, cost-effectiveness, independence from patient adherence, prevention of disease progression, and improved quality of life.Keywords: intervention, treatment, sustained release drug delivery, MIGS, medication, selective laser trabeculoplasty
