With short operating times, a good safety profile, and rapid recovery, micro/minimally invasive glaucoma surgeries (MIGS), in combination with phacoemulsification (PHACO-MIGS) has revolutionized the surgical glaucoma management landscape.

Indeed, over 90% of MIGS procedures currently carried out at the Singapore National Eye Centre (SNEC) are done using a PHACO-MIGS protocol.

Patients who have undergone PHACO-MIGS generally demonstrate promising clinical outcomes, such as a substantial reductions in intraocular pressure.

Importantly, however, there is currently no prospective real-world information on the effectiveness of PHACO-MIGS (compared to other treatments) on quality of life outcomes.

The PROMinsight team are excited to share some preliminary patient-reported data from an ongoing clinical trial led by Prof. Tina Wong, Head and Senior Consultant in the Glaucoma Service at SNEC.

Patients in Prof Wong’s trial answered the GlauCAT™ instrument before undergoing PHACO-MIGS and again 6 months after the procedure. Recently released data from the study team has revealed large improvements in seven GlauCAT™ domains at 6 months post-surgery compared to pre-surgery values.

For example, patients reported a 15 point (out of 100) improvement in Visual Symptoms; a 9.5 point improvement in Concerns; an 8.5 point increase in Emotional well-being; and a 7 point improvement in Ocular Comfort Symptoms.

These findings are amongst the first in the world to show that PHACO-MIGS can significantly improve a range of quality of life outcomes in patients with early stage glaucoma and cataract and demonstrate the importance of using valid, precise and comprehensive glaucoma-specific instruments such as GlauCAT™.

The PROMinsight team are already planning other rigorously designed studies to provide novel and robust real-world evidence to researchers, clinicians, policy-planners, and decision-makers about the real-world efficacy of PHACO-MIGS from the patients’ perspectives using GlauCAT™.

Update

The PROMinsight team are excited to share the final results of a clinical trial led by Prof. Tina Wong, Head and Senior Consultant in the Glaucoma Service at SNEC.

Between 2019 and 2023, 83 patients answered the GlauCAT™ instrument before undergoing PHACO-MIGS and again 6 months after the procedure. 

Large and statistically significant score increases were observed in four GlauCAT™ domains at 6 months post-surgery compared to pre-surgery values.

For example, patients reported a 13% improvement in Visual Symptoms; a 7.5% improvement in Concerns; a 6.4% point improvement in Ocular Comfort Symptoms, and a 6.3% improvement in General Convenience.

Absolute improvements were also noted in six of the remaining eight GlauCAT™ domains although these did not reach statistical significance.

Reduction in intraocular pressure was the clinical parameter contributing most to the significant improvements observed across the 4 GlauCAT™ domains. However this was likely because reduced intraocular pressure results in less medication use (i.e. less need for eye drops) and therefore less side effects, concerns and costs for patients.