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Achieving Surgical Success and Patient Satisfaction With MIGS: International Perspectives (CME Monograph)
Activity Description
More than 40% of patients with glaucoma require maximal medical treatment (MMT) to reach their target intraocular pressure (IOP). MMT can fail to achieve IOP targets, however, because of overt treatment failure or the presence of ocular surface disease, which can lead to a lack of adherence to medication schedules. For these patients, another strategy is needed to reach target IOP. Bleb-based minimally invasive glaucoma surgery (MIGS) procedures balance efficacy and safety and provide a viable option for patients with moderate to severe glaucoma who cannot achieve their IOP goal on MMT. As compared with tube-shunt surgery, subconjunctival bleb-based MIGS also provides favorable postsurgical quality of life outcomes. Optimization of bleb health is an important component of this strategy, and new data provide insight into best practices for antimetabolite treatment and follow-up examination. The desired results of this educational activity are for ophthalmologists to gain the knowledge and competence they need to ensure the best possible outcomes for their patients with glaucoma, now and as new therapies are approved.
Target Audience
This educational activity is intended for glaucoma specialists and other ophthalmologists caring for patients with glaucoma.
Learning Objectives
Upon completion of this activity, participants will be better able to:
- Discuss the safety and efficacy of MIGS devices for patients with moderate to severe glaucoma
- Describe clinically relevant quality of life outcomes associated with various MIGS procedures
- Choose appropriate MIGS procedures according to individual patient factors
- Integrate evidence-based best practices for prevention of bleb failure into practice
Faculty
Joseph F. Panarelli, MD (Chair)
Associate Professor of Ophthalmology
Chief, Division of Glaucoma Services
Glaucoma Fellowship Director
NYU Langone Eye Center
New York, New York
Ike K. Ahmed, MD, FRCSC
Professor
University of Utah
Salt Lake City, Utah
Assistant Professor
Director, Glaucoma and Advanced Anterior Segment Surgery (GAASS) Fellowship
Research Director, Kensington Eye Institute
University of Toronto
Toronto, Canada
Keith Barton, MD, FRCP, FRCS
Consultant Ophthalmologist
Moorfields Eye Hospital and London Claremont Clinic
Honorary Reader, UCL Institute of Ophthalmology
London, United Kingdom
Anna T. Do, MD
Clinical Glaucoma Fellow
Department of Ophthalmology
New York University Langone Health
New York, New York
Julian Garcia-Feijoo, MD, PhD
Professor and Chairman
Ophthalmology Department
Hospital Clinico San Carlos
Universidad Complutense de Madrid
Madrid, Spain
Marlene R. Moster, MD
Professor of Ophthalmology
Thomas Jefferson University School of Medicine
Attending Surgeon, Glaucoma Service
Wills Eye Institute
Philadelphia, Pennsylvania
Disclosure Policy Statement
It is the policy of New York Eye and Ear Infirmary of Mount Sinai that the faculty and anyone in a position to control activity content disclose any real or apparent conflicts of interest relating to the topics of the educational activity in which they are participating. They are also required to disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentations. New York Eye and Ear Infirmary of Mount Sinai is committed to providing its learners with quality CME activities and related materials that promote improvements in healthcare and not the proprietary interests of a commercial interest and, thus, has established policies and procedures in place that identify and resolve all conflicts of interest prior to the execution or release of its educational activities. Full disclosure of faculty/planners and their commercial relationships, if any, follows.
Faculty
Ike K. Ahmed, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Aequus BioPharma, Inc; Aerie Pharmaceuticals, Inc; Akorn, Inc; Alcon; Allergan; ArcScan, Inc; Bausch & Lomb Incorporated; Beaver-Visitec International; Beyeonics Surgical Ltd; Camras Vision, Inc; Carl Zeiss Meditec, Inc; CorNeat Vision Ltd; Ellex; ELT Sight, Inc; ElutiMed; Equinox; Genentech, Inc; Glaukos Corporation; Injectsense, Inc; IRIDEX Corporation; iSTAR; Ivantis Inc; Johnson & Johnson Vision Care, Inc; Kelotec Inc; LayerBio, Inc; Leica Microsystems; MicroOptx; MicroSurgical Technology; Minosys Cellular Devices Inc; New World Medical, Inc; Ocular Instruments; Ocular Therapeutix, Inc; Omega Ophthalmics; Polyactiva Pty Ltd; Sanoculis Ltd; Santen Inc; ScienceBased Health; Sight Sciences; Strõma Medical Corporation; Thea Pharmaceuticals Limited; Vialase, Inc; Vizzario; and W. L. Gore & Associates, Inc; Contracted Research: Aerie Pharmaceuticals, Inc; Alcon; Allergan; Camras Vision, Inc; Glaukos Corporation; Ivantis Inc; Johnson & Johnson Vision Care, Inc; New World Medical, Inc; and Santen Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Alcon; Allergan; Carl Zeiss Meditec, Inc; Johnson & Johnson Vision Care, Inc; MicroSurgical Technology; and Mundipharma International.
Keith Barton, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Advanced Ophthalmic Implants Pte Ltd; Alcon; Allergan; Calpain Therapeutics; EydD Pharma SA; Eye Tech Care; Glaukos Corporation; iSTAR; Ivantis Inc; Laboratoires Théa; pH PHARMA; Radiance Therapeutics, Inc; Santen Pharmaceutical Co, Ltd; and Transcend Medical, Inc; Contracted Research: Allergan; Aquesys, Inc; Laboratoires Théa; and Merck & Co., Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Aquesys, Inc; and MedEther Ophthalmology Ltd.
Anna T. Do, MD, has no relevant commercial relationships to disclose.
Julian Garcia Feijoo, MD, PhD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Alcon; Allergan; Glaukos Corporation; iSTAR; and Santen Pharmaceutical Co, Ltd; Contracted Research: Alcon; Allergan; Glaukos Corporation; iSTAR; Ivantis Inc; and Santen Pharmaceutical Co, Ltd; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Alcon; Allergan; and Santen Pharmaceutical Co, Ltd.
Marlene R. Moster, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Alcon; Allergan; Merck & Co., Inc; Qura Inc; and SOLX, Inc; Contracted Research: Aeon Astron Corporation; Aerie Pharmaceuticals, Inc; Alcon; Allergan; Bausch & Lomb Incorporated; Glaukos Corporation; InnFocus Inc; IOP Ophthalmics; IRIDEX Corporation; New World Medical, Inc; SOLX, Inc; and Valeant; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Alcon; Allergan; Bausch & Lomb Incorporated; Merck & Co., Inc; New World Medical, Inc; and TBI.
Joseph F. Panarelli, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Aerie Pharmaceuticals, Inc; Allergan; CorneaGen; Glaukos Corporation; New World Medical, Inc; and Santen Inc.
New York Eye and Ear Infirmary of Mount Sinai Peer Review Disclosure
Tak Yee Tania Tai, MD, has no relevant commercial relationships to disclose.
Kateki Vinod, MD, has no relevant commercial relationships to disclose.
Editorial Support Disclosures
Erika Langsfeld, PhD; Cynthia Tornallyay, RD, MBA, CHCP; Barbara Aubel; and Michelle Ong have no relevant commercial relationships to disclose.
Medical Writer: Tony Realini, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Aerie Pharmaceuticals, Inc; iSTaR; New World Medical, Inc; and Notal Vision.
Disclosure Attestation
The contributing physicians listed above have attested to the following:
- that the relationships/affiliations noted will not bias or otherwise influence their involvement in this activity;
- that practice recommendations given relevant to the companies with whom they have relationships/affiliations will be supported by the best available evidence or, absent evidence, will be consistent with generally accepted medical practice; and
- that all reasonable clinical alternatives will be discussed when making practice recommendations.
Accreditation Statement
The New York Eye and Ear Infirmary of Mount Sinai is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This educational activity was developed and implemented in collaboration with MedEdicus LLC.
AMA Credit Designation Statement
The New York Eye and Ear Infirmary of Mount Sinai designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Grantor Statement
This continuing medical education activity is supported through an unrestricted educational grant from Santen Inc.
Off-Label Discussion
This CME activity includes discussion of unlabeled and/or investigative uses of drugs. Please refer to the official prescribing information for each drug discussed in this activity for FDA-approved dosing, indications, and warnings.
New York Eye and Ear Infirmary of Mount Sinai Privacy & Confidentiality Policies
https://www.nyee.edu/education/cme
CME Provider Contact Information
For questions about this activity, call 917-270-7571.
Disclaimer
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of New York Eye and Ear Infirmary of Mount Sinai, MedEdicus LLC, Santen, EyeNet, or the American Academy of Ophthalmology.
This CME activity is copyrighted to MedEdicus LLC ©2020. All rights reserved. 204
Available Credit
- 1.50 AMA PRA Category 1 Credit™
- 1.50 Participation
Clicking Register indicates that you have reviewed the CME information for this activity.
Learning Method and Medium
This educational activity consists of a supplement and nine (9) study questions. The participant should, in order, read the learning objectives contained at the beginning of this supplement, read the supplement, answer all questions in the post test, and complete the Activity Evaluation/Credit Request form. To receive credit for this activity, please follow the instructions provided on the post test and Activity Evaluation/Credit Request form. This educational activity should take a maximum of 1.5 hours to complete.