Eyeworld

70 | EYEWORLD | SUMMER 2024 G UCOMA I WISH I HAD … by Ellen Stodola Editorial Co-Director About the physicians Michael Boland, MD, PhD Associate Professor of Ophthalmology Mass Eye and Ear Harvard Medical School Boston, Massachusetts Arsham Sheybani, MD Associate Professor of Ophthalmology and Visual Sciences Washington University School of Medicine in St. Louis St. Louis, Missouri Jessie Wang, MD Glaucoma Fellow Duke Eye Center Durham, North Carolina going into practice are doing comprehensive or another anterior segment specialty where they'll be doing cataract surgery. I think it's helpful for them to also have the skillset to perform angle-based surgeries, especially for parts of the country where access to a glaucoma surgeon might be limited." Even for those planning to go into glau- coma, Dr. Wang sees this change as positive because these surgeons will be getting more training in their chosen specialty. "Just because the requirement changed, it didn't stop me from doing both," she said. "Different surgeries can be introduced at different time points, depending on the clini- cal presentation and patient goals. In general, MIGS procedures can be introduced at earlier time points and can work better when you introduce them earlier in the disease. And for patients who need a tube or trab, they will probably eventually still need them at some point," she said, adding that she doesn't think MIGS makes tubes or trabs obsolete. Changes you wish to see in ophthalmology training requirements: new MIGS guidelines continued on page 72 R ecent changes to training for residents in ophthalmology by the Accredita- tion Council for Graduate Medical Education (ACGME) have seen the addition of a requirement for trainees to perform five MIGS procedures as the prima- ry surgeon. Meanwhile, requirements for tube shunts and trabeculectomy remain in place, but those in training can be the surgeon or assistant on five procedures to meet this requirement. Several surgeons weighed in on these changes, with a general consensus that it was time to account for these MIGS procedures and tech- niques in training requirements. Jessie Wang, MD, who recently complet- ed her residency training at the University of Chicago, has plans to specialize in glaucoma and will be starting her fellowship at the Duke Eye Center shortly. Dr. Wang said that she was fortunate in training to gain experience with both MIGS and tube shunts. "The guidelines are changing to require MIGS, but you can just assist on tubes, and I think for most people it's a positive change," she said. "Many residents Trabeculectomy represents an opportunity for trainees to learn skills applicable beyond glaucoma, including incision, dissection, and closure of conjunctiva and sclera. Source: Lucy Shen, MD, and Daniel Liebman, MD, MBA

• Blank Page
• Blank Page (1)