Clinical Scorecard: Optimizing MIGS for Practice and Center Success
At a Glance
| Category | Detail |
|---|---|
| Condition | Minimally Invasive Glaucoma Surgery (MIGS) |
| Key Mechanisms | Techniques include microbypass stents, canaloplasty, and sustained-release drug delivery systems. |
| Target Population | Adult patients with refractory primary open-angle glaucoma (POAG) who have failed prior medical and/or surgical therapy. |
| Care Setting | Ambulatory Surgical Center (ASC) |
Key Highlights
- MIGS expands options for patients and improves OR predictability.
- MIGS is a core capability impacting clinical outcomes and ASC economics.
- Most MIGS cases are performed during cataract surgery with minimal operational burden.
- Predictable techniques and favorable safety profiles make MIGS suitable for ASCs.
- Operational efficiency is crucial for ASC profitability.
Guideline-Based Recommendations
Diagnosis
- Capture disease severity, medication burden, and prior interventions for payer alignment.
Management
- Utilize techniques like iStent Infinite, Hydrus Microstent, and Omni System for effective pressure lowering.
Monitoring & Follow-up
- Monitor for iris pigmentation changes with iDose TR and Durysta implants.
Risks
- Potential for false passage into collector channels or breakthrough into the anterior chamber with certain devices.
Patient & Prescribing Data
Adults with refractory POAG.
MIGS can be combined with cataract surgery and other interventions for enhanced outcomes.
Clinical Best Practices
- Standardize setup and anticipate angle work to minimize scheduling disruptions.
- Train the surgical team to ensure efficient intraoperative workflow.
- Implement a tiered scheduling approach based on the MIGS mechanism being used.
Related Resources & Content
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