New-Generation MIGS: Which MIGS for Which Patient? Clinical Pearls for Selection and Technique (Archived CME Multimedia Program)

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Activity Description

Recent advances in the surgical management of glaucoma are changing treatment strategies, with safe and efficacious minimally invasive techniques and devices now available. Some minimally invasive glaucoma surgery (MIGS) techniques and devices must be used in conjunction with cataract surgery, whereas subconjunctival MIGS incorporates the filtering capacity of a bleb to increase the potential to reduce intraocular pressure. Subconjunctival MIGS has been shown to reduce intraocular pressure by at least 20% for most patients, while relieving drop burden. Common side effects include postoperative needling, nonpersistent loss of best-corrected visual acuity, and transient hypotony. Subconjunctival MIGS requires bleb formation, and antimetabolite treatment contributes to surgical success. The desired results of this activity are to prepare clinicians to competently incorporate MIGS into their surgical repertoire and develop the ability to select the best MIGS according to individual patient needs and desires.

MODULE 1: Introduction to MIGS

Sahar Bedrood, MD, PhD

MODULE 2: A 60-Year-Old Fortune 500 Executive

Jonathan Myers, MD

MODULE 3: A 69-Year-Old with Worsening Visual Fields After ALT

Joseph F. Panarelli, MD

MODULE 4: Two Cases Using an Ab Externo Approach

Brian A. Francis, MD, MS

MODULE 5: A 64-Year-Old with High Myopia and Visual Field Loss

Sahar Bedrood, MD, PhD

MODULE 6: Two Cases of Glaucoma Progressing on Maximal Medical Therapy

Arsham Sheybani, MD

Target Audience

This activity intends to educate glaucoma specialists and other ophthalmologists.

Learning Objectives

Upon completion of this activity, participants will be better able to:

  • Compare the characteristics of established and new MIGS procedures
  • Summarize the efficacy data of subconjunctival MIGS procedures
  • Summarize the safety data of subconjunctival MIGS procedures
  • Apply evidence to select appropriate subconjunctival MIGS procedures for a variety of patients
  • Review appropriate antimetabolite use for bleb-based MIGS
Course summary
Course opens: 
11/12/2019
Course expires: 
12/31/2025

Faculty




image
Ike K. Ahmed, MD, FRCSC (Chair)
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
Division Head, Division of Ophthalmology
Trillium Health Partners
Co-Medical Director, TLC
Mississauga, Canada
Medical Director, Prism Eye Institute
Mississauga and Brampton, Canada
imageSahar Bedrood, MD, PhD
Ophthalmologist
Acuity Eye Group
Adjunct Clinical Assistant Professor
USC Roski Eye Institute
Los Angeles County + USC Medical Center
Pasadena, California
imageBrian A. Francis, MD, MS
Stieger Endowed Chair
Professor of Ophthalmology
Doheny and Stein Eye Institutes
Department of Ophthalmology
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, California
imageJonathan Myers, MD
Director, Glaucoma Service
Wills Eye Hospital
Associate Professor of Ophthalmology
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia, Pennsylvania
imageJoseph F. Panarelli, MD
Associate Professor of Ophthalmology
Chief, Division of Glaucoma Services
Glaucoma Fellowship Director
NYU Langone Eye Center
New York, New York
 
imageArsham Sheybani, MD
Assistant Professor of Ophthalmology
Fellowship Director, Glaucoma and Anterior Segment Surgery
Residency Program Director, Ophthalmology
Washington University in St Louis
St Louis, Missouri

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.

Disclosures

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; Alcon; Allergan; ArcScan, Inc; Bausch & Lomb Incorporated; Beaver-Visitec International; Camras Vision, Inc; Carl Zeiss Meditec, Inc; CorNeat Vision Ltd; Ellex; ElutiMed; Equinox; Genentech, Inc; Glaukos Corporation; IanTECH; Injectsense, Inc; IRIDEX Corporation; iSTAR; Ivantis Inc; Johnson & Johnson Vision Care, Inc; Kelotec Inc; LayerBio, Inc; Leica Microsystems; MicroOptx; New World Medical, Inc; Omega Ophthalmics; Polyactiva Pty Ltd; Sanoculis Ltd; Santen Inc; ScienceBased Health; Sight Sciences; Strōma Medical Corporation; TrueVision; 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; and Johnson & Johnson Vision Care, Inc.

Sahar Bedrood, MD, PhD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Allergan; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Allergan; and Glaukos Corporation.

Brian A. Francis, MD, MS, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Beaver-Visitec International; Diopsys, Inc; Glaukos Corporation; NeoMedix Corporation; and Valeant; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Bausch & Lomb Incorporated.

Jonathan Myers, 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; Allergan; Glaukos Corporation; and MicroOptx; Contracted Research: Aerie Pharmaceuticals, Inc; Alcon; Allergan; Bausch & Lomb Incorporated; Diopsys, Inc; Glaukos Corporation; Heidelberg Engineering GmbH; Novartis Pharmaceuticals Corporation; Shire; Sight Sciences; and ZEISS; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Aerie Pharmaceuticals, Inc; Allergan; and IRIDEX Corporation.

Joseph F. Panarelli, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Allergan; 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): Aerie Pharmaceuticals, Inc; Allergan; and Glaukos Corporation.

Arsham Sheybani, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Allergan; and Katena Products, Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Glaukos Corporation.

New York Eye and Ear Infirmary of Mount Sinai Peer Review Disclosure

Kateki Vinod, MD, has no relevant commercial relationships to disclose.

Editorial Support Disclosures

Erika Langsfeld, PhD; Cynthia Tornallyay, RD, MBA, CHCP; Kimberly Corbin, CHCP; Barbara Aubel; and Michelle Ong have no relevant commercial relationships to disclose.

Disclosure Attestation

The contributing physicians listed above have attested to the following:

  1. that the relationships/affiliations noted will not bias or otherwise influence their involvement in this activity;
  2. 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
  3. that all reasonable clinical alternatives will be discussed when making practice recommendations.

Accreditation Statement

imageThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of New York Eye and Ear Infirmary of Mount Sinai and MedEdicus LLC. The New York Eye and Ear Infirmary of Mount Sinai is accredited by the ACCME to provide continuing medical education for physicians.

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 Allergan.

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 212-870-8127.

To Obtain AMA PRA Category 1 Credit

To obtain AMA PRA Category 1 Credit™ for this activity, view the webinar modules and complete the posttest and evaluation. Upon passing, you will receive your certificate immediately. You must score 70% or higher to receive credit for this activity, and may take the test up to 2 times. Upon registering and successfully completing the post test, your certificate will be made available online and you can print it or file it.

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, or Allergan.

This continuing medical education activity is jointly provided by New York Eye and Ear Infirmary of Mount Sinai and MedEdicus LLC.      
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This CME activity is copyrighted to MedEdicus LLC ©2019. All rights reserved. 191

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This educational activity has expired. You will not be able to claim credit for this activity.