Eyeworld

80 | EYEWORLD | SEPTEMBER 2022 by Liz Hillman Editorial Co-Director About the physician Leon Herndon Jr., MD Director of the Glaucoma Service Duke Eye Center Durham, North Carolina Relevant disclosures Herndon: None G UCOMA need a trab, and he worries that fewer surgeons will be able to perform and manage this in the future. "I believe in MIGS and intervening earlier with safer procedures, but if you look at the data, the number of trabeculectomies being performed even in training programs is going down. In a few years we'll have relatively few physicians who know how to do a trabeculecto- my," he predicted. There are a couple of reasons why Dr. Herndon thinks trabeculectomy is going down. One is the Tube Versus Trabeculectomy Study, which Dr. Herndon said demonstrated that tube surgery was a reasonable option for patients with severe disease, thus leading to some pro- cedures being replaced with glaucoma drainage W hile there has been a revolution within the last decade in terms of glaucoma management— surgical and medical—Leon Herndon Jr., MD, would argue that trabeculectomy is still the most basic of glaucoma management procedures. "I think when you say 'basic,' the conno- tation is that it's simple. It's not. Trabeculecto- my itself is not a challenging surgery, but the management postop is very challenging," Dr. Herndon said. "It's the gold standard. Even though first popularized in late 1970s, there is still nothing else out there that's going to get the pressure as low as a trabeculectomy will." Even among the myriad of options for glau- coma patients now available, Dr. Herndon said that he thinks some patients are still going to The case for trabs: 'Trabeculectomy is not dead' BACK TO BASICS Watch this complimentary ASCRS Satellite CME Program on demand now. Reviews surgical and therapeutic glaucoma treatments Features MIGS (standalone and next generation devices) and the latest info on medical therapy Designated for 1.0 AMA PRA Category 1 Credit TM Find this and other ASCRS Satellite CME Programs at www.ascrs.org/satellite-cme. The Glaucoma Treatment Spectrum: Meds, Sustained Delivery, and MIGS

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