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Article

Addressing Surgeon Hesitancy in Glaucoma Surgery

Patients are open to minimally invasive procedures when they are presented as alternatives to drops.

By: Inder Paul Singh, MD, Savak “Sev” Teymoorian, MD, MBA, Christine Funke, MD

Glaucoma Physician January 1, 2026 Page(s): 16-17, 20

Clinical Scorecard: Addressing Surgeon Hesitancy in Glaucoma Surgery

At a Glance

Category	Detail
Condition	Glaucoma
Key Mechanisms	Minimally invasive procedures for IOP control and disease management.
Target Population	Patients with primary open-angle glaucoma and high intraocular pressure.
Care Setting	Ophthalmology clinics and surgical centers.

Key Highlights

Minimally invasive glaucoma surgery (MIGS) offers low-risk, effective IOP control.
Early surgical intervention improves visual outcomes and reduces complications.
Patients are generally receptive to surgical options when well-informed.
Topical drops have poor adherence rates and can lead to disease progression.
Procedural pharmaceuticals provide targeted, sustained IOP control.

Guideline-Based Recommendations

Diagnosis

Assess IOP and disease progression regularly.
Consider patient history and adherence to treatment.

Management

Prioritize minimally invasive procedures over topical drops.
Utilize selective laser trabeculoplasty (SLT) as a primary treatment.

Monitoring & Follow-up

Regular follow-up to evaluate IOP and visual outcomes.
Monitor for complications associated with both drops and procedures.

Risks

Chronic drop use can lead to ocular surface disease and vision loss.
Delayed surgical intervention may complicate treatment outcomes.

Patient & Prescribing Data

Patients with glaucoma seeking effective IOP management.

Minimally invasive procedures can reduce treatment burden and improve satisfaction.

Clinical Best Practices

Educate patients on the risks and benefits of both drops and surgical options.
Frame surgical interventions as proactive rather than last resort.
Encourage open communication to build patient confidence in surgical options.

Related Resources & Content

Gurnani B, Tripathy K. Minimally invasive glaucoma surgery. StatPearls. January 2024.

Savak “Sev” Teymoorian

Specialties: Ophthalmology

Bio: Savak “Sev” Teymoorian, MD, MBA, is a physician author whose work focuses on glaucoma management and surgical decision-making. In Glaucoma Physician, he has written about surgeon hesitancy in glaucoma surgery, including the role of minimally invasive procedures as alternatives to long-term topical drop therapy.

Contributions:

https://glaucomaphysician.net/issues/2024/june/real-world-pearls-for-idose-tr-implantation/

https://glaucomaphysician.net/issues/2026/january/addressing-surgeon-hesitancy-in-glaucoma-surgery/

Christine Funke

Affiliations: Barnet Dulaney Perkins

Specialties: Ophthalmology

Bio: Christine Funke, MD, is affiliated with Barnet Dulaney Perkins in Phoenix, Arizona, and focuses on glaucoma care. In a Glaucoma Physician discussion from the 2026 American Society of Cataract and Refractive Surgeons meeting, she addressed interventional glaucoma and the shift toward earlier procedural treatment.

Teymoorian, MD, MBA

Specialties: Ophthalmology

Bio: Teymoorian, MD, MBA, is an ophthalmology author who wrote on drug delivery innovations for glaucoma treatment in Ophthalmology Management. Their published work centers on glaucoma therapy and ophthalmic disease management, including topics such as medication adherence, procedural treatment approaches, and cytomegalovirus retinitis.

Savak Sev Teymoorian

Specialties: Surgery

Bio: Savak Sev Teymoorian, MD, MBA, is a medical doctor with expertise in glaucoma surgery. He is a contributing author to medical discussions on the management of glaucoma, emphasizing early surgical intervention over traditional reliance on eye drops. His work focuses on improving patient outcomes through minimally invasive procedures and addressing clinician hesitancy regarding glaucoma surgeries. Dr. Teymoorian contributes to advancing the understanding of therapeutic strategies aimed at managing intraocular pressure and preventing vision loss in glaucoma patients.

Savak “Sev” Teymoorian

Specialties: Ophthalmology

Bio: Savak “Sev” Teymoorian, MD, MBA, is a glaucoma specialist focused on advancing therapeutic approaches for glaucoma management. His expertise includes clinical experience with novel sustained-release implants for glaucoma, including the recently FDA-approved iDose TR implant, which delivers travoprost via an intracameral sustained-release system. He contributes insights to improve patient adherence challenges and overall quality of life in glaucoma care by integrating innovations in microinvasive glaucoma surgery and procedural pharmaceuticals.