Rates of Structural Progression Four Years After the ELIOS Procedure

Glaucoma treatment consists of two objectives: preserving the patient's quality of life and avoiding blindness. This requires not only a reduction in IOP but the ultimate goal of reducing disease progression.

We have performed more than 200 ELIOS procedures, most of which were combined with phacoemulsification. A retrospective review of our first 69 eyes with mild (n = 50), moderate (n = 10), or severe (n = 9) primary open-angle glaucoma and at least 4 years of follow-up indicated a 35% mean reduction in IOP. More importantly, 75% of patients were medication-free at 4 years. Only four eyes required a filtering surgery in subsequent years following treatment. Compared with the medicated preoperative IOP, there was a 20% reduction in IOP and a 1.35 reduction in medications at 4 years. For me, these are the sort of results our patients need.

Moreover, we observed structural changes on OCT and found that the retinal nerve fiber layer thickness slope flattens to values comparable to age-related decline. Although the level of IOP reduction is not comparable with trabeculectomy, the disease is well-controlled without the need for a bleb.

Given our results, I believe ELIOS is an effective way to control early stage glaucoma and can be conveniently integrated into routine cataract surgery.