Expanding use of surgical devices in patients with all stages of glaucoma will increase the role of surgery in the glaucoma treatment paradigm over the next five years.
There are four FDA-approved minimally invasive glaucoma surgery (MIGS) stents in the US: the Glaukos iStent and iStent Inject, Allergan XEN Gel Stent, and Ivantis Hydrus. The total will increase to five when the Santen PreserFlo Microshunt reaches the milestone. The FDA has accepted Santen’s PMA submission for review, Santen announced in July, and approval could occur before the end of 2020.
These newer glaucoma surgical devices generally have been used in glaucoma patients with mild to moderate glaucoma.
However, the Santen PreserFlo has shown in clinical trials the ability to lower IOP to a level similar to conventional glaucoma surgery, extending its application to more advanced glaucoma patients. The Glaukos iStent Infinite is also designed to be used in more advanced-stage glaucoma patients and is expected to be approved soon in the US.
Glaucoma is the world’s second leading cause of blindness. The disease affects over 100 million people around the globe, according to Market Scope estimates. Another 42 million individuals have ocular hypertension, a condition that often precedes glaucoma. Once the disease is diagnosed, medication—rather than surgery—is the treatment option chosen most frequently for all stages of glaucoma.
Surgery is typically chosen only when medications are no longer able to control disease progression. In 2019, only 2.0 percent of diagnosed glaucoma patients globally were treated surgically.
Market Scope’s “2020 Glaucoma Surgical Device Market Report” analyzes the latest trends in these devices, including the latest developments for MIGS devices.
An emerging trend is mixing and matching more than one of the newer surgical options, such as MIGS and canal surgery devices, to treat patients who require greater lowering of IOP. We estimate that about 20 percent of glaucoma surgeries in US patients being treated for cataracts and glaucoma are receiving more than one surgical device.
While the use of surgical devices is growing, lasers are the most frequently chosen device to treat early-stage glaucoma patients no longer responding to medication.
Laser options include selective laser trabeculoplasty (SLT) and cyclophotocoagulation laser.
Glaucoma surgery is performed by glaucoma specialists, cataract surgeons, and general ophthalmologists, and the report analyzes the types and volumes of glaucoma surgeries performed by each of these subspecialists.
Market Scope’s “2020 Glaucoma Surgical Device Market Report” was published in August.