Eyeworld

68 | EYEWORLD | JULY 2023 G UCOMA by Manjool Shah, MD Glaucoma Editor I t was so great to return to San Diego for the ASCRS Annual Meeting, back to the glory of annual meet- ings BC (Before COVID). From the palpable buzz in the air at the Main Stage sessions to courses that were standing room only, the energy that characterizes the ASCRS Annual Meeting was felt everywhere. As an EyeWorld section editor, I had the pleasure of sticking around until the very last session to review and highlight some of the best glaucoma papers presented during the meeting's scientific sessions. I was struck by the quality of the work, often presented by our most junior members and rising stars. The future of glaucoma is bright, as is the future of ASCRS as a society that recognizes the interplay between glaucoma and the rest of anterior segment surgery. In this issue, we build on this theme of interconnectedness. Davinder Grover, MD, MPH, Patrick Gooi, MD, and Paul Harasymowycz, MD, share pearls on the evolving family of goniot- omy, trabeculotomy, and canaloplasty. Quickly, these techniques have become the workhorse of Schlemm's canal-based surgical interventions for all types of glaucoma. With advancements in microinstrumentation and novel devices, these approaches are becoming part of the compre- hensive anterior segment surgeon's toolkit. While our contributors recognize a need for additional innovation and research to determine the nuances of patient selection and predicting outcomes, the democratization of glaucoma sur- gery through procedures like these is exciting. And who knows, some of the medical students, residents, and fellows who led the charge at the ASCRS Annual Meeting paper sessions may help us answer these fundamental questions in the years to come. The ultimate exemplar of the need for team-based connections in ophthalmology is uveitic glaucoma. I have fond memories of Friday afternoon glaucoma clinics a few hall- ways down from our uveitis specialist, where patient after patient presented with a combi- nation of profound ocular hypertension from steroid-induced glaucoma, seclusion pupillae and iris bombe, and hypertensive uveitis. Jonathan Eisengart, MD, Ninani Kombo, MD, and Aubrey Tirpack, MD, discuss the challenges that these eyes often present to their team but highlight the importance of working together to manage the multiple axes of inflammation, steroids, post-surgical healing, and potentially systemic manifestations of ophthalmic disease. While uveitic glaucoma presents the ultimate rock-and-a-hard-place situation, our outstand- ing contributors discuss tried and true as well as novel interventional strategies to overcome these tough cases. Kavitha Sivaraman, MD, and Michael Greenwood, MD, bring their unique experience as cornea specialists to the ever-important con- versation about the ocular surface as it pertains to the glaucoma patient. They highlight the multimodal effects that chronic topical drug therapy can have on the ocular surface and adnexa, in terms of patient comfort and visual quality, as well as preoperative optimization prior to cataract, glaucoma, and cornea surgery. Advancements in sustained drug delivery, the earlier utilization of laser trabeculoplasty, and the emerging world of standalone MIGS will hopefully chip away at the burden our contribu- tors highlighted. The ASCRS Annual Meeting's glaucoma programming and scientific content, as well as the caliber of commentary presented by these outstanding contributors, shows me that while we have a long road ahead of us, the creativity, collaboration, and connectedness that exemplify ASCRS will help us light the way. The future of glaucoma is bright The future of glaucoma is bright, as is the future of ASCRS as a society that recognizes the interplay between glaucoma and the rest of anterior segment surgery.

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