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Focal Points 2019 Module: Current and Emerging Uses of Adjunctive Pharmacologic Agents in Glaucoma Surgery

CME Credit
  • Up to 2.0 credits of General CME
Product Number
0202069V

Media Type: eBook

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Focal Points 2019 Module: Current and Emerging Uses of Adjunctive Pharmacologic Agents in Glaucoma Surgery

Focal Points 2019 Module: Current and Emerging Uses of Adjunctive Pharmacologic Agents in Glaucoma Surgery

Despite decades of research, intraocular pressure reduction remains the sole therapeutic intervention proven to slow glaucoma progression. Trabeculectomy and glaucoma drainage devices aim to reduce IOP by draining aqueous humor to the subconjunctival space. Two newer devices, the XEN Gel Stent (Allergan) and the InnFocus MicroShunt (InnFocus/Santen), also produce de novo subconjunctival outflow pathways.

The long-term success of any glaucoma filtration operation depends upon maintenance of aqueous humor flow to the subconjunctival space, which can be compromised by postoperative episcleral Tenon fascial fibrosis. Many factors increase the likelihood of excessive fibrosis following glaucoma surgery. It is vital for a surgeon to efficiently recognize these characteristics in order to maximize post-operative success.

This Focal Points module discusses risk factors that lead to scarring and surgical failure, reviews applications of antifibrotics in glaucoma surgery and evaluates the current roles of these medications. Investigational approaches to the modulation of wound healing in glaucoma surgery are also discussed.

By completing this module, you will be able to:

  • Recognize common underlying causes of early and late failure of glaucoma filtering surgery.
  • Summarize various application methods of adjunctive antifibrotic agents in traditional glaucoma operations and discuss the advantages and disadvantages of these agents in the intraoperative and early postoperative period.
  • Consider how antifibrotic agents may be applied to novel subconjunctival filtering devices.
  • Evaluate emerging pharmacologic methods for optimizing surgical outcomes.

Authors: Thomas V. Johnson, MD, PhD; Angelo P. Tanna, MD

Focal Points issues review the most crucial advances and feature insights to help you integrate tested research into your practice.

Subscribers receive 12 issues a year, plus access to the Focal Points digital archive.

This issue includes an audio version.

To access the audio version of this module, scan the QR code in the print module or click the link within the digital module.

To access this issue from your laptop or desktop computer, log in to www.aao.org/myonlineproducts with your Academy username and password.

To access this issue from your smartphone or tablet, use the free AAO eBooks app. For eBook features, requirements and licensing, visit: aao.org/ebooks. Please allow up to 90 minutes for receiving an access key (via email) that will allow you to retrieve your eBook after purchase.

CME Information
The American Academy of Ophthalmology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Ophthalmology designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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© 2019, American Academy of Ophthalmology