Glaucoma Surgery

WGA Consensus Series

Free sample

Glaucoma surgery was the topic of the eleventh World Glaucoma Association Consensus meeting. Glaucoma surgery in primary open-angle glaucoma was also the topic of the second Consensus meeting held in 2005. For the current version, angle closure and angle-closure glaucoma, as well as the secondary glaucomas, were also included. But the expansion of the subject matter is not the only reason for the timing of this new Consensus. Perhaps even more important is the explosion of new surgical ideas and techniques, which are revolutionizing the surgical approach to the glaucoma patient. The idea of targeting anatomic outflow and inflow pathways and individualizing care has opened so many new possibilities for improving surgical outcomes. Furthermore, outcomes are no longer only focused on lowering intraocular pressure, but also on enhancing health- and vision-related quality of life.

As with prior meetings, it was a daunting task to seek and obtain consensus on a broad subject matter for which there are so many different opinions. As it is unclear how each of us decides how we practice and the evidence to guide us often is sparse, this consensus — as well as the others — is based not only on the published literature, but also on expert opinion. Although consensus does not replace and is not a surrogate for scientific investigation, it does provide considerable value, especially when the desired evidence is lacking.

The goal of this consensus is to provide a foundation for glaucoma surgery and how it can be best done in clinical practice. Identification of those areas for which we have little evidence, and therefore the need for additional research, always is a high priority. We hope that this consensus report will serve as a benchmark of our understanding of what is known and what we would like to know. However, this Consensus Report is expected to be just a beginning that will be revised and improved with the emergence of new evidence, and new and improved surgical procedures.

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Additional Information

Publisher
Kugler Publications
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Published on
Oct 4, 2019
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Pages
512
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ISBN
9789062999057
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Language
English
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Genres
Medical / Ophthalmology
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This content is DRM protected.
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Preface

Childhood is the topic of the ninth World Glaucoma Association Consensus. There has been only sparse attention to the diagnosis and treatment of childhood glaucoma. Both pediatric ophthalmologists and glaucoma specialists provide care for such children. In some instances, they manage these individuals alone and, in others, the management is shared. For this consensus, the participation of both groups was solicited. The global faculty, consisting of leading authorities on the clinical and scientific aspects of childhood glaucoma, met in Vancouver on July 16, 2013, just prior to the World Glaucoma Congress, to discuss the reports and refine the consensus statements.

As with prior meetings, it was a daunting task to seek and obtain consensus on such a complicated and nuanced subject. It is unclear how each of us decides how we practice, and evidence to guide us often is sparse. It is remarkable how few high level studies have been conducted on the management of childhood glaucoma. Hence, this consensus, as with the others, is based not only on the published literature, but also on expert opinion. Although consensus does not replace and is not a surrogate for scientific investigation, it does provide considerable value, especially when the desired evidence is lacking.

The goal of this consensus was to provide a foundation for diagnosing and treating childhood glaucoma and how it can be best done in clinical practice. Identification of those areas for which we have little evidence and, therefore, the need for additional research also was a high priority. We hope that this consensus report will serve as a benchmark of our understanding. However, this consensus report, as with each of the others, is intended to be just a beginning. It is expected that it will be revised and improved with the emergence of new evidence.

Robert N. Weinreb, Chair

 

Preface

Childhood is the topic of the ninth World Glaucoma Association Consensus. There has been only sparse attention to the diagnosis and treatment of childhood glaucoma. Both pediatric ophthalmologists and glaucoma specialists provide care for such children. In some instances, they manage these individuals alone and, in others, the management is shared. For this consensus, the participation of both groups was solicited. The global faculty, consisting of leading authorities on the clinical and scientific aspects of childhood glaucoma, met in Vancouver on July 16, 2013, just prior to the World Glaucoma Congress, to discuss the reports and refine the consensus statements.

As with prior meetings, it was a daunting task to seek and obtain consensus on such a complicated and nuanced subject. It is unclear how each of us decides how we practice, and evidence to guide us often is sparse. It is remarkable how few high level studies have been conducted on the management of childhood glaucoma. Hence, this consensus, as with the others, is based not only on the published literature, but also on expert opinion. Although consensus does not replace and is not a surrogate for scientific investigation, it does provide considerable value, especially when the desired evidence is lacking.

The goal of this consensus was to provide a foundation for diagnosing and treating childhood glaucoma and how it can be best done in clinical practice. Identification of those areas for which we have little evidence and, therefore, the need for additional research also was a high priority. We hope that this consensus report will serve as a benchmark of our understanding. However, this consensus report, as with each of the others, is intended to be just a beginning. It is expected that it will be revised and improved with the emergence of new evidence.

Robert N. Weinreb, Chair

 

Intraocular Pressure is the subject for the fourth Consensus report published under the auspices of the AIGS, now renamed as the World Glaucoma Association (WGA). The active participation in our Project Forum e-Room started in January, 2007, by expert members of the various consensus committees. As done with prior reports, the preliminary document was circulated to each of the member societies of the WGA, and additional comments were solicited for the document. Each member Society also was invited to send a representative to attend the consensus meeting that was held in Fort Lauderdale, Florida on May 5, 2007. The report then was discussed extensively during the Consensus Meeting and Consensus Statements were revised following these discussions.
Intraocular Pressure is a topic that touches the essence of our subspecialty. Its measurement is a vital aspect of glaucoma diagnosis and treatment. For now, it is the only modifiable risk factor. Measurement of IOP is a relatively recent – one century – addition to our diagnostic armamentarium. Even though the measurement of IOP is relatively simple, it is by no means uncomplicated. The greatest limitation is probably the paucity of measurements that are obtained in practice. Although continuous IOP-measurement is on the horizon, it still is not ready for clinical practice.
Arriving at a consensus often can be circuitous and filled with compromises. However, this opportunity is used to critically assess the evidence and develop consensus points. The reader will find this consensus report instructive, practical, and thought-provoking. Moreover, it has great potential to impact patients, both individually and collectively, through both their care and research.

 

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