The following article is a part of Ophthalmology Advisor’s conference coverage of the Southeastern Educational Congress of Optometry (SECO) 2021, held in Atlanta and virtually from April 28 to May 2, 2021. The team at Ophthalmology Advisor will be reporting on the presentations offered by these leading experts in optometry and ophthalmology. Check back for more from the SECO 2021 Meeting.

 

For patients who do not comply with glaucoma drops, more drops are not the answer, according to Arkadiy Yadgarov, MD, of Omni Eye Services of Atlanta. The problem, his presentation outlines, has to do with the law of diminishing returns. He explains that compliance decreases as you add additional medicines and that the efficacy of each subsequent drop actually decreases. Dr Yadgarov’s presentation at the Southeastern Educational Congress of Optometry (SECO) 2021 offered a variety of alternative options and explains how optometrists can partner with surgeons to keep patients’ vision intact. 


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The presentation, Glaucoma 2021, reviewed the latest options for drop noncompliant patients, including less frequently-dosed pharmaceutical therapies, drug-eluting implants, laser procedures, and invasive surgeries. 

In regards to drugs, Dr Yadgarov detailed how prostaglandins need only once-a-day dosing — a much more ideal drop regime than prior therapies, especially considering the difficulty in drop instillation and deleterious side effects many patients report. These options include latanoprostene bunod, netarsudil, and netarsudil + latanoprost. These formulations are not without their own side effects profile, which the lecture reviews, but for some patients, they may provide a more manageable treatment.

For other patients, Dr Yadgarov recommended treatment with implants such as a biodegradable, intracameral bimatoprost eluting device, or MIGS drainage stents that are implanted during cataract surgery. Although ophthalmologists are responsible for implanting these, optometrists often oversee these patients and make initial recommendations based on their clinical experiences. Dr Yadgarov presented an overview of the available devices and dispels some myths regarding their effectiveness.

The course also took into account the application of selective laser trabeculoplasty (SLT) as a first-line approach. The presentation offered a deep dive into the relevant research for SLT effectiveness, explaining when other procedures — such as micropulse cyclophotocoagulation, trabeculotomy, or canaloplasty — are appropriate. 

Visit Ophthalmology Advisor’s conference section for complete coverage of the SECO 2021 Meeting and more.

 

Reference

Yadgarov A. Glaucoma 2021. Presented at: Southeastern Educational Congress of Optometry (SECO) 2021 Annual Meeting; April 28-May 2, 2021; Atlanta, GA. Course 501.