AAO 2024: The role of MIGS in earlier intervention and safer techniques

Vikas Chopra, MD, highlights the impact of minimally invasive glaucoma surgery (MIGS) on ophthalmology and patient care during an instructional course he led during the 2024 American Academy of Ophthalmology meeting held October 18 to 21 in Chicago, Illinois. Chopra emphasizes how these techniques allow for earlier interventions and safer surgical options. The course combined lectures with hands-on wet lab training, providing attendees with personalized instruction to master the nuances of MIGS.

Chopra underscores the importance of technology and collaboration with the industry in advancing surgical practices, ultimately prioritizing patient safety and predictable outcomes. He shares his commitment to sharing valuable insights and pearls learned from experience, illustrating the collaborative nature of medical education.

Chopra, who is from Doheny Eye Institute at the University of California, Los Angeles, shares some of the key takeaways in this interview with Ophthalmology Times.

Video Transcript:

Editor’s note: The below transcript has been lightly edited for clarity.

Vikas Chopra, MD:

Hi. I’m Vic Chopra from Doheny UCLA in Southern California, and today I was a participant and instructor in a course that was teaching minimally invasive glaucoma surgery. This is a fantastic area, an area that has really rejuvenated ophthalmology and glaucoma management in particular, because we’re now more easily able to do intervention earlier, because we have much safer techniques. So this is a course that, again, has a lecture associated with a wet lab thereafter, where you work one on one with attendees who sign up for this course, and what you’re teaching them is minimally invasive glaucoma surgeries. So you sit down with them and you go through all the steps in a dry lab setting and to understand how to implant these devices or how to do the surgery. Many of them have already had some experience, and they want refreshers. Technology, as we discussed in a previous talk, is so critical to us, and again, the evolution of ophthalmology has been amazing. Partnership with industry, where we give them feedback as to this is the things we need, and then they develop these technologies for us that we can use for safer surgeries.

Ultimately, it’s all about the patient and providing better outcomes. So what we want to do is impart safety, and you want predictability. So these procedures, if you can teach pearls, and it’s very difficult sometimes to teach pearls. There’s nothing written in sort of books and all of that. You learn these in the hallways, talking to your colleagues. How do you manage this? How do you manage that? So that’s what we’re imparting. We’re taking specialists who have done these cases, hundreds and probably thousands of cases, and taking those pearls, putting them together, and teaching that to the to the attendees.

What has been the feedback from attendees?

I’m biased as an instructor, but I think the feedback is amazing. Of course, I feel like everyone’s rating is five out of five, but generally speaking, I’m kind of kidding. The feedback has been extremely positive. And the academy, the way they determine courses and selection of courses is the attendees and participants grade the course, and the highest-rated courses typically actually are even given a star, which our courses have, which is the top 10% of best-rated courses. The Academy will not actually select courses that get a poor attendance or poor score. They want courses that have been been rated well. That being said, they always include newer courses, because you need to kind of keep things fresh.

What do you hope attendees take away from the training?

For patient safety first, so do no harm. So you really want to be very confident in what you do so you have to understand your limitations. I even have limitations, and there are cases that I’ll ask my colleagues like Brian Francis, MD, and others and say, hey, maybe can you give me some pearls about this case? Or maybe you do this case with me, and I think that’s always good to keep it humble to that degree that we want what’s best for them.