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^TM 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^TM 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^TM.

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^TM.

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 GlauCATTM instrument before undergoing PHACO-MIGS and again 6 months after the procedure. 

Large and statistically significant score increases were observed in four GlauCATTM 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 GlauCATTM 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 GlauCATTM 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.