Eyeworld

G RESEARCH HIGHLIGHT UCOMA G laucoma specialists have a clear idea of the outcomes they would like to see in patients with medical or surgical treatment, but how do those outcomes match what patients want? Patients are more focused on the ability to maintain an independent lifestyle, according to the results of focus group inter- views led by U.K. researchers published in the British Journal of Ophthlamology. 1 While IOP reduction is the usual measure of treatment success among ophthalmologists and in clinical trials in glaucoma, it's unclear if this translates into improvements valued by patients, according to the researchers. The re- searchers also pointed out differing perceptions that patients may have of medical vs. surgical treatment, with the latter usually viewed as a last resort. Researchers invited patients at the Glauco- ma Service of Nottingham University Hospital, Nottingham, U.K., to take part in one of seven focus group sessions led by two researchers. There was a total of 45 participants (ages 52–90 years). Patients in three of the groups had had medical treatment only, while patients in the other four groups had previous surgical treatment. Surgical treatment was not speci- fied, although trabeculectomy was mentioned. Patients had an overall solid understanding of IOP, visual acuity, and visual fields. Most of the patients were content with their glaucoma treatments and control of the disease. Insights from the participants Researchers found several themes from the focus group sessions: • Both medical and surgical patients said they preferred using eye drops for as long as need- ed to avoid surgery. • Many patients relied heavily on guidance from their physicians regarding glaucoma surgery. Patients were willing to try newer surgical treatments, if their physician said they were beneficial. • Many patients expressed anxiety about having surgery; they were most afraid of losing eye- sight and the fact that efficacy wasn't guaran- teed. • Although patients understood and appre- ciated IOP control, many said that IOP reduction on its own was not a meaningful treatment outcome. They were more con- cerned about maintaining enough sight to live independently and pursue life's activities. by Vanessa Caceres Contributing Writer Independent living is a key outcome of glaucoma treatment for patients About the sources Howard Krauss, MD Director of ophthalmology Pacific Neuroscience Institute at Providence St. Joseph Health Santa Monica, California Rafael Salazar II, MHS President and CEO Rehab U Practice Solutions Augusta, Georgia Ian Saldanha, PhD Assistant professor Brown University Providence, Rhode Island References 1. Kulkarni BB, et al. Exploring patients' expectations and preferences of glaucoma surgery outcomes to facilitate healthcare delivery and inform future glau- coma research. Br J Ophthalmol. 2019;103:1850–1855. 2. Li T, et al. Patient-reported outcomes measures and patient preferences for minimally invasive glaucoma surgical devices. Eye. 2020;34:205–210. Relevant disclosures Krauss: None Salazar: None Saldanha: None continued on page 88 86 | EYEWORLD | MARCH 2020 Contact Krauss: hkrauss@pacificneuro.org Salazar: rafi@rehabupracticesolutions.com Saldanha: ian_saldanha@brown.edu

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