ABiC Blog

With Dr. Mark J. Gallardo, MD

In the monthly ABiC Blog, MIGS expert Dr. Mark Gallardo will highlight ongoing developments in the world of MIGS – and the important role to be played by ABiC and the various MIGS options in the glaucoma treatment algorithm. Dr. Gallardo is a glaucoma specialist and is one of the pioneers of the ABiC procedure. He is in private practice at El Paso Eye Surgeons, Texas, and is affiliated with Hospitals of Providence Sierra Campus, Las Palmas Medical Center and University Medical Center of El Paso, Texas, USA.

MIGS Post-Operative Management

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The ABCs of ABiC

With the start of the new school year, my young son is about to enter pre-K and has been practicing his ABCs and 123s. Of course, we use song to help him remember his letters and numbers in harmony. Because of this, I find it a good time to discuss the ABCs of ABiC. Of course I will not do it in song, primarily because I would sound like Alfalfa from the Little Rascals singing, “I’m in the mood for love” to Darla. But, what I can do is describe the steps and surgical pearls of ABiC, so that you can find rhythm in the operating room.

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Filtration Surgery. A Horror from the Past?

For decades, we have been hoping for alternatives to this highly invasive therapy. Thankfully, within the last five years, we have had an antidote in the form of micro-invasive glaucoma surgeries or MIGS. Although MIGS are not a replacement for filtering procedures, they have provided us with an alternative method for managing patients with uncontrolled mild to moderate disease. MIGS have also afforded us the option to augment cataract surgery in an effort to reduce or eliminate a patient’s medication burden.

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Diving into the Suprachoroidal Space

It’s July, it’s hot, and it’s time for a beach vacation on the California coast (no financial interest in California) and some surfing lessons. To novices like myself, the waters in La Jolla can be treacherous, with rolling waves and, sometimes, an undertow. To others, especially those with experience in the water, the surf is viewed as mild and easily navigated.

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Why the Eye’s Outflow System is Like a Highway

As I continue my studies of natural aqueous outflow, I have become happily aware of just how intricate and complex the eye can be. But as a resident, and then fellow, and sorrowfully admitting, as a doc who is now well beyond the years of being considered a YO (young ophthalmologist) my understanding of trabecular outflow was infantile at best. I believe my meager understanding of the conventional outflow system was multifactorial in nature. One principle reason is our limited in-depth discussions of the ultrastructural make-up of and biophysiology of the outflow system.

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With All the Options We Have to Enhance Outflow, It’s a Great Time to be a Plumber (Part II)

September 28, 1978: a day of infamy for glaucoma. A new drug that was to be milder on the eye and used earlier in the treatment paradigm to prevent blindness – a breakthrough in care – was announced during the CBS Evening News with Walter Cronkite. Cronkite’s opening statement read, “Glaucoma, a painful disease of the eye that can lead to blindness, is not curable. Drugs have been around for years, which can control the disease but often with such unpleasant side effects some patients found the control worse than the condition. There was an announcement in New York City today, which may end that dilemma for millions of Americans”. The drug was timolol maleate.

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With All the Options We Have to Enhance Outflow, It’s a Great Time To Be a Plumber (Part 1)

I can still remember the afternoon when I, a senior resident fascinated by technology, approached my long-time mentor and informed him that I had decided to apply for a fellowship in glaucoma. I recall how he looked up from his seated position with his steel gray-blue eyes and intimidating stare. I remember his exact words that he delivered with a shocked, dismayed, and disappointed voice: “Why on earth would you want to be a plumber?”.

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The Road less Traveled

Back in 2006, as an excited, energetic, and freshly graduated glaucoma surgeon, I attended the American Glaucoma Society Meeting in Dana Point, California. There, for the first time, I was introduced to an amazing new thought process; there was world outside of tubes and trabs. At my reps encouraging, I signed-up for and attended a symposium on canaloplasty and was blown away. The procedure seemed so elegant, the technology so advanced.

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MIGS: a time for less is now

As a glaucoma specialist and member of the American Glaucoma Society I am privy to very intellectual discussions regarding challenging cases and various treatment options that are currently on the market. It seems that throughout the history of medicine, scientists, clinicians and surgeons have striven to develop treatment options that are more effective than their predecessors, offering enhanced efficacy and safety profiles. I was reminded of this fact while reading an absolutely wonderful book, The Emperor of all Maladies, which chronicles the evolution of cancer therapy and the resistance innovative minds encountered when sharing their novel treatment ideas.

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From our base in Fremont, California, our team is working hard to develop a suite of novel glaucoma treatment technologies that will enable you to treat across the full spectrum of the glaucoma disease process.

Continue to the Glaucoma-iTrack.com website.

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California 94538

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