Customizing Care and Minimizing Risk With MIGS

How should eye care providers approach patients with concurrent glaucoma and catracts? And when does cataract surgery alone fall short? In this episode of CRST: The Podcast, Anupam Laul, OD, FAAO, and Sahar Bedrood, MD, PhD, work through 3 real-world cases covering ocular hypertension with visually significant cataracts, primary open-angle glaucoma with rapid RNFL progression, and acute angle closure with a large crystalline lens. The discussion covers SLT timing, MIGS selection, sustained-release drug delivery, IOL choice in glaucoma patients, and when trabeculectomy remains the right call.

Poojitha Balakrishnan, MD, MPH, PhD, recaps her article “Using Imaging to Understand the Causes and Sequelae of Hypotony,” written with Jithin Yohannan, MD, MPH, and featured in the March/April issue of Glaucoma Today. Hypotony is a significant complication of glaucoma surgery, and identifying its causes and sequelae can be a challenge with slit-lamp examinations and indirect ophthalmoscopy alone. Dr. Balakrishnan discusses the value of ocular imaging modalities such as OCT and ultrasound as additional tools for diagnosis and management.

Reay H. Brown, MD, and Shibandri Das, MD, each present a scenario that highlights how minimally invasive procedures can be used to address specific obstacles in glaucoma management. The two patient cases were featured in their article, “Customizing Care and Minimizing Risk With MIGS,” which was written with Shivani Kamat, MD, and featured in the May/June 2026 issue of Glaucoma Today.

On this episode of Survey Says, a special edition of GT: The Podcast, I. Paul Singh, MD, is by joined by Reena Garg, MD, to discuss next steps for a patient who is having difficulty adhering to his topical medication regimen. With no progression shown on visual field testing, Dr. Singh raises the question of whether the current treatment is appropriate or if the compliance issue warrants exploring a different option such as repeat selective laser trabeculoplasty, drug delivery, or surgery. Dr. Garg weighs in, and later, they compare their opinions with the results of a social media poll of GT’s audience and Dr. Singh shares what he did.

Glaucoma specialists share insights into treating uveitis-glaucoma-hyphema (UGH) syndrome, as featured in the January/February 2026 issue of Glaucoma Today. Roya Garakani, DO, recaps, “Surgical Decision-Making in Patients With UGH Syndrome,” outlining options for patients with UGH syndrome who require glaucoma surgery in addition to an IOL procedure. Then, Mahsaw Mansoor, MD, recaps, “Selecting an IOL and Fixation Technique for Patients With UGH Syndrome,” which was written with Nicole Fram, MD, and presents a case-based approach to surgical management of in-the-bag UGH syndrome secondary to dead bag syndrome.

Welcome to GT: The Podcast! In this episode, glaucoma specialists share the approaches and pearls they wish they had discovered sooner, as featured in the November/December 2025 issue of Glaucoma Today. Kateki Vinod, MD, and Won I. Kim, MD, share their reflections on IOP monitoring and how home tonometry has changed their respective practices. Later, Jenny Lu describes age-related neuroretinal alterations and how these changes can mimic glaucomatous damage, as covered in an article by Shuning Li, MD, PhD, and Ying Han, MD, PhD.

Welcome to GT: The Podcast! In this episode, Chelvin Sng, BA, MA, MBBChir, MMed, MRCS(Ed), FRCS(Ed), FAMS, recaps her article, “The Paul Glaucoma Implant,” which was featured in the November/December issue of Glaucoma Today. The Paul Glaucoma Implant (Advanced Ophthalmic Innovations) is a glaucoma drainage device designed to fulfill the unmet need for a tube shunt with greater efficacy but a lower risk of hypotony. Dr. Sng reviews device characteristics, surgical technique, postoperative management, and clinical data.

Welcome to GT: The Podcast! In this episode, Mohamed M. Khodeiry, MD, MSc, recaps his article, “Glaucoma Intrascleral Tube Surgery,” written with James Richardson-May, MD, and Ahmed Elbably, MSc, FRCS, and featured in the July/August issue of Glaucoma Today. A surgical modification called glaucoma intrascleral tube surgery (GITS) may help address some postoperative complications associated with subconjunctival stent implantation. Dr. Khodeiry discusses the development of GITS, specifics of the surgical technique, early outcomes, and future directions.

Rachel Chapman recaps her article, “Tube Erosion,” which was written with Matthew Henderson, MD; Dan Arreaza-Kaufman, MD; Jonathan Eisengart, MD; and Mary Qiu, MD, and was featured in the May/June issue of Glaucoma Today. Glaucoma drainage implants can lower IOP and preserve patients’ vision, but the devices carry the risk of tube erosion, a serious complication that requires prompt surgical management. Ms. Chapman reviews the rates of tube erosion, risk factors, strategies for prevention, and techniques for surgical revision.

On this episode of Survey Says, a special edition of GT: The Podcast, I. Paul Singh, MD, is joined by guests Emily Schehlein, MD, and H. George Tanaka, MD, to review a real case from his practice involving a patient with glaucoma with a history of SLT and MIGS. Though the patient’s IOP is at target, she is very unhappy with topical medication. The group discusses the importance of quality of life and weighs possible next steps, including drug delivery, repeat SLT, surgical intervention, or continuing as is. Later, the guests find out what Dr. Singh did, and they compare their opinions with the results of a social media poll of GT’s audience.