Eyeworld

FEBRUARY 2025 | EYEWORLD BONUS ISSUE | 3 G by Sumit "Sam" Garg, MD Chief Medical Editor These technologies coupled with AI algorithms enable personalized treatment approaches and predictive modeling for glaucoma progression. Other areas where AI is making headway are intraoperative identification of landmarks for angle-based procedures and aids to help with drop identification and administration for pa- tients who still rely on topical drops. Pharmaceutical delivery systems are another area of innovation. We now have sustained-release implants, such as Durysta (bimatoprost intracameral implant, AbbVie) and iDose TR (travoprost intracameral implant, Glaukos), that promise to provide consistent IOP control and reduce the need for daily eye drops, with more innovation on the horizon. The field of interventional glaucoma con- tinues to evolve, offering patients safer, more effective, and convenient options while reduc- ing the burden of disease management. These innovations mark a promising future for preserving vision and enhancing quality of life for individuals with glaucoma. This bonus issue of EyeWorld focuses on how glaucoma treatment has evolved and the exciting current offerings for our glaucoma patients and future directions that will continue to change how we manage this potentially blinding disease. G laucoma manage- ment has undergone a renaissance in the past decade. Early in my career, the mainstay for glaucoma therapy was primarily topical drops, and surgical interven- tion was largely trabeculectomy and tubes. We have seen significant progress in recent years, with advancements in technology and surgical techniques reshaping the management of this chronic condition. Microinvasive glaucoma surgery (MIGS) represents one of the most im- pactful innovations, allowing for minimal tissue disruption/manipulation, reducing the risk of complications, and shortening recovery times. Additionally, innovations in drug deliv- ery and laser technologies have helped evolve glaucoma into one of the fastest growing subspecialities within ophthalmology. In our training program, we have seen a huge uptick in the number of our trainees who are pursuing glaucoma fellowship, largely in part due to the significant transformation we have seen in the past decade or so and the popularization of interventional glaucoma. Advancements in laser therapies have also contributed to the evolution of glaucoma management. Selective laser trabeculoplasty (SLT) has emerged as a first-line or adjunctive treatment, leveraging its ability to lower IOP by targeting outflow pathways. Innovations in laser systems have made these procedures more precise, effective, and accessible. The Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial is a landmark clinical trial that evaluated the efficacy and cost-effectiveness of SLT as a first-line treatment for open angle glaucoma and ocular hypertension. The study demonstrated that SLT is as effective as topical medications in lowering IOP. SLT reduced the need for glaucoma medications, with more than 70% of patients achieving target IOP without eye drops over 3 years. Diagnostic tools have improved alongside surgical innovations. Improvements in optical coherence tomography (OCT) and IOP monitoring systems offer earlier and more accurate detection of glaucoma progression. The glaucoma renaissance This bonus issue of EyeWorld focuses on how glaucoma treatment has evolved and the exciting current offerings for our glaucoma patients and future directions that will continue to change how we manage this potentially blinding disease.

• Cover