Survey of Glaucoma Practice Patterns Among Members of The Philippine Glaucoma Society
Edgar Felipe U. Leuenberger, MD, DPBO1, James Paul S. Gomez, MD, DPBO1, Karlo Paolo L. Alejo, MD, DPBO2, Robert Edward T. Ang, MD, DPBO1, Maria Zita Zagala-Meriales, MD, DPBO3, Pamela C. Allarey, MD, DPBO4, Aldo Mar B. Cariaga, MD, DPBO5, John Mark S. De Leon, MD, DPBO6, Sammy L. Ang, MD, DPBO7, For the Philippine Glaucoma Society
1 Asian Eye Institute
2 De la Salle University Medical Center
3 Makati Medical Center
4 The Medical City
5 Baguio General Hospital and Medical Center
6 The Department of Health Eye Center East Avenue Medical Center
7 Calamba Eye Center and Calamba Medical Center
Correspondence: Edgar Felipe U. Leuenberger, MD, DPBO
Asian Eye Institute
9F Phinma Plaza, Rockwell Center, Makati City, Philippines;
Disclosure: This study was funded by an unrestricted grant from the Philippine Glaucoma Society. The corresponding author and study team independently conducted all phases of the research and assume full accountability for its content.
Objective: To identify the glaucoma clinical practice patterns among the members of the Philippine Glaucoma Society (PGS) from 2015 to 2016 using an online survey.
Methods: An online link was sent to each consenting PGS member which directed them to two poll sites. These sites asked questions about demographics and their preferred clinical practice patterns. Frequency and percent distributions were used to analyze the data.
Results: There was a high response rate from PGS members at 97% (42 out of 43 members). More than half of respondents (51%, n=22) defined glaucoma as glaucomatous optic neuropathy with an evident visual field loss. IOP was routinely measured by 90% (n=38) of the respondents with majority preferring to use the Goldmann applanation tonometer (GAT) (98%, n=41). Gonioscopy was done on all new patients by all PGS members but only 62% did regular gonioscopy on follow-up consultations. Most of the respondents relied on the 90D lens (88%) to assess the optic nerve. Visual field examination (VFE) was routinely requested by all respondents.
Pachymetry and anterior segment optical coherence tomography (AS-OCT) were used sparingly at only 43% and 12% respectively. Appositional angle closure was addressed by performing laser iridotomy with majority of the respondents preferring a site that is covered by the upper eyelid (57%). Prostaglandin analogues were the top choice as first-line monotherapy for eyes with open-angle glaucoma. Majority of the respondents (55%) opted to do laser trabeculoplasty (LTP) as an adjunct to medical therapy. Mitomycin-C was the preferred intraoperative antimetabolite for trabeculectomy by 98% (n=41). Ahmed (71%, n=30) was the more favored glaucoma drainage device (GDD) by our respondents over Baerveldt (19%, n=8).
Conclusion: This survey showed majority of the glaucoma practices of PGS members appear to adhere to the current clinical practice guidelines.
Keywords: glaucoma, online survey, practice patterns, Philippines