Eyeworld

47 EW GLAUCOMA March 2019 interests with Qura. Dr. Mansouri has financial interests with Sensimed and Implandata. Contact information Mansouri: kwmansouri@gmail.com Moster: marlenemoster@gmail.com Sit: Sit.Arthur@mayo.edu is CE marked in Europe, and Qura (Boston) with QSmart. Implandata is currently in clinical trials with a new suprachoroidal device, with the first successful implantation in human patients occurring in December 2018. This device would be im- planted as part of glaucoma filtering surgery. QSmart, which is still in development and testing in animal models, is 2.8 mm. When asked how he thought continuous IOP monitoring could change clinical care, Kaweh Man- souri, MD, professor of ophthalmol- ogy, University of Colorado, Denver, and Montchoisi Clinic, Lausanne, Switzerland, took it a step back. "Initially, it may not change so much because we need to learn how to interpret that data. We are used to very few data points in glauco- ma management when it comes to IOP," he said. "There will be a period where prospective studies have to be conducted to understand IOP variations, then we will be able to assess continuously and accurately how these IOP variations affect this patient's glaucoma management." However, one can imagine uses for such technology, such as assessing the effect of therapy. "Let's say Mrs. X has a sensor in her eye and the IOP is higher than the doctor would deem safe for her optic nerve," Dr. Moster said. "They would change the therapy and be able to assess with accurate pressure readings day and night whether the IOP lowering meets the goal that was predetermined by the physician. The same would hold true for surgi- cal procedures." A secondary effect of contin- uous IOP monitoring could be a reduction in patient visits because they would no longer need manu- al tonometry. This could result in not only time saved on the part of the patient and physician but cost savings as well. 2 This could be a double-edged sword, Dr. Moster said. "You want patients to come in to re- new their medications, to know you are still quite interested in how they are doing. You can't do it completely from afar," she said. Until continuous IOP monitor- ing devices are easily available and more widespread, Dr. Moster said she doesn't foresee the pattern of decision making changing among ophthalmologists caring for glau- coma patients. She does, however, expect continuous IOP monitoring devices that could dramatically change this decision-making process to start becoming available within the next 5 years. "People have been talking about continuous IOP monitoring for decades," Dr. Sit said, "but I think we are on the cusp of having some things that will be clinically useful." EW References 1. Mantzioros N. The history of the meaning of the word glaucoma. www.glaucoma.org.au/ media/1281/history-of-the-word-glaucoma. pdf. Accessed Jan. 24, 2019. 2. Dong J, et al. Potential savings from visit reduction of continuous intraocular pres- sure monitoring. J Curr Glaucoma Pract. 2018;12:59–63. Editors' note: Dr. Sit has financial interests with Injectsense (Emeryville, California). Dr. Moster has financial Imagining continued from page 45

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