Clinical Scorecard: Thirty Years Together in a Career Defined by Change

At a Glance

Key Highlights

• Transition from extracapsular cataract surgery to phacoemulsification with small incisions and foldable intraocular lenses.
• Integration of combined cataract surgery with glaucoma procedures such as trabeculectomy using mitomycin C.
• Continuous evolution of ophthalmic surgical technology including femtosecond lasers and MIGS devices over the past 30 years.

Guideline-Based Recommendations

Diagnosis

• Assess glaucoma status and cataract severity preoperatively.
• Monitor intraocular pressure and optic nerve health regularly.

Management

• Use phacoemulsification with small incisions to minimize surgical trauma.
• Consider combined cataract surgery with trabeculectomy in patients with coexisting glaucoma.
• Employ MIGS devices as appropriate for glaucoma management.

Monitoring & Follow-up

• Close postoperative observation for complications such as retinal tears.
• Regular follow-up to assess function and safety of implanted glaucoma devices.

Risks

• Potential for surgical complications such as peripheral retinal tears during cataract surgery.
• Device recalls requiring patient counseling and close observation.

Patient & Prescribing Data

Patients with glaucoma on medical therapy undergoing surgery

Patients may be on multiple glaucoma medications including pilocarpine, timolol, and oral acetazolamide prior to surgical intervention.

Clinical Best Practices

• Adopt new surgical technologies that improve patient outcomes while maintaining safety.
• Combine glaucoma and cataract procedures when clinically indicated to optimize care.
• Maintain resilience and adaptability in clinical practice to incorporate evolving innovations.
• Provide thorough patient education regarding device recalls and postoperative expectations.

References

• Ophthalmology Management