Nova Eye Medical (EYE) Discussion, page-21

From everything I have read (check out the journal extract posted by @hatmopit), I believe there is an increasingly strong consensus among Glaucoma specialists that drops do not work as a result of non-compliance and that MIGS is rapidly becoming the go to approach for dealing with Glaucoma.

In a speech presented by Ike Ahmed (one of the leading Glaucoma and MIGS specialists in the world), he said that he has actually become anti-meds due to not only the issue of non compliance, but that it also fails to prevent trabecular disease

LINK: Finding Where Canaloplasty Fits with Ike Ahmed - YouTube

The way I approach this though is adopting the perspective of a patient (quality of life driven) and the doctor (profit driven). For a patient, a single iTrack Advance procedure (even more than one) would be substantially better than having to commit to decades of eye drops. From the perspective of the doctor, given iTrack Advance is not a cure, they will still be making recurring revenue from follow up appointments (to confirm that pressure has not risen etc.).

Ike Ahmed argues that: “In early-stage disease, before fibrosis has become unmanageable, dilation of the canal can improve outflow. Canaloplasty is a far better option for these patients than decades of eyedrops which – even if effective and well-tolerated – cannot interrupt meshwork fibrosis.”

Keep in mind that iTrack Advance is a very fast minimally invasive surgery (operation only takes a few mins) which is probably also one of the safest Glaucoma procedures you can get. With the old procedure and stent-based procedures, I could understand resistance due to the difficulty of the procedure for the former, and having an implant placed in your eye for the latter. With canaloplasty, you are simply restoring the natural function of the eye, which (imo) would significantly reduce resistance to having this procedure earlier.

I am not a medical professional though and I can only hypothesise based on my own research, but from what I have read it seems like there is going to be a big market for a treatment like iTrack Advance which quickly and smoothly restores the natural function of the eye. Seems like zero downside for getting a treatment like this

I believe doctors are still seeing MIGS and traditional surgery as equal, and that the traditional approach of delaying surgery as long as possible will be reversed with the emergence of MIGS (and a greater understanding of the safety, efficacy and efficiency of this new glaucoma treatment)