In this second episode of a special two-part series on the Interventional Glaucoma Podcast, host Gok Ratnarajan is joined by Anselm Juenemann, Dan Lindfield, Jose Belda, and Nils Loewen to share insights from their first 100 ELIOS cases. They discuss patient selection, technique, and post-op management, while also exploring strategies to reduce the learning curve. The conversation covers the safety and efficacy of ELIOS, and how to manage medications post-op for the best outcomes. The experts highlight the importance of clinical experience in achieving reliable results and provide valuable tips for glaucoma surgeons.
The Interventional Glaucoma Podcast
Episode 13: ELIOS – What I learned from my first 100 cases (Part 2)
Key Takeaways
- Patient Selection Matters : ELIOS is most effective for patients with open-angle glaucoma, early-to-intermediate stages, and those with deep anterior chambers. It is less suitable for cases involving neovascular or traumatic glaucoma due to unpredictable outflow system changes.
- Reproducibility and Confidence in Outcomes : ELIOS provides consistent and reliable IOP reduction, making it a dependable choice for glaucoma surgeons. Most patients achieve good, predictable outcomes.
- Comparisons with Other MIGS Procedures : Unlike implant-based MIGS devices like iStent or Hydrus, ELIOS is independent of precise implant placement, reducing variability in results. It also allows for additional procedures later if needed.
- Medication Reduction Strategy : Surgeons are gaining confidence in reducing post-op glaucoma medications more aggressively. While some initial caution is necessary, many patients maintain controlled IOP following the ELIOS procedure, even after stopping medications.
- Safe Option for Advanced Cases : As experience with ELIOS grows, some surgeons are using it in more advanced glaucoma cases as a safer alternative to invasive surgeries. While these patients may still require medications or additional interventions, ELIOS provides a low-risk treatment option.
Guests
Mr Gok Ratnarajan
Mr Gok Ratnarajan is a Consultant Ophthalmic Surgeon specialising in Cataract, Glaucoma and Anterior Segment Reconstructive Surgery. He is Director of Glaucoma Services at the prestigious Queen Victoria Hospital.
Mr Ratnarajan is fellowship trained in glaucoma, complex cataract as well as anterior segment reconstructive surgery. He gained this experience during his 3 specialist surgical fellowships at The Oxford Eye Hospital, The Western Eye Hospital in London and at the University of Toronto, Canada.
Prof Nils Loewen
Prof. Dr. Nils Loewen is the Chair of the Artemis Cluster of Frankfurt. He specialises in glaucoma and cataract care and is renowned for providing innovative, minimally invasive procedures that simultaneously address cataract and refractive vision needs. His extensive research includes over 110 published works which focus on bioengineering the ocular outflow system to lower intraocular pressure. He actively contributes to the field through his roles in prominent ophthalmological societies and as a reviewer for 18 scientific journals.
Prof Anselm Juenemann
Prof. Dr Anselm Jünemann is a specialist for the posterior eye segment and has been working at the Viselle Eye Center Erlangen since 2019. At the University Eye Hospital Erlangen, he has led numerous scientific projects in glaucoma research since 2006. From 2014 to 2018, he was head physician at the Department and Polyclinic of Ophthalmology at the University Medical Center Rostock. Since 2019, he has been back in Erlangen as a glaucoma specialist at the Viselle Eye Center. In addition to his expertise in the diagnosis and treatment of diseases of the posterior eye segment, Prof. Jünemann also has many years of experience in the field of cataract surgery and refractive surgery. He also carries out various methods of corneal transplantation, ablation of superficial corneal scars, removal of pronounced astigmatism, and pterygium surgery.
Mr Dan Lindfield
Mr Dan Lindfield is a consultant ophthalmologist and cataract surgeon in Guildford and Farnham who specialises in cataracts and glaucoma surgery, including laser therapies for glaucoma, such as SLT, trabeculectomy, and minimally invasive glaucoma surgery (MIGS). He has an extensive portfolio of research and academic work which is published in leading peer-reviewed journals.
Dr Jose Belda
Dr Jose Belda is a Surgeon Ophthalmologist at Visionker Eye Clinic, Clínica Oftálica, and head of the Ophthalmology Service at the University Hospital of Torrevieja. He is a reference expert in the approach and treatment of Glaucoma, standing out for his great work in the different clinical and hospital centers where he has worked. His extensive training in ophthalmology includes stays in centers of international prestige such as the Bascom Palmer Eye Institute, Moorfields Eye Hospital, and the Hospital for the Prevention of Blindness in Mexico DF.
Additional Resources
Follow Dr Gok Ratnarajan on Social:
Gokulan Ratnarajan | LinkedIn
Follow Dr Anselm Juenemann on Social:
Anselm Jünemann | LinkedIn
Follow Mr Dan Lindfield on Social:
Dan Lindfield | LinkedIn
Follow Dr Jose Belda on Social:
Dr Jose Belda | LinkedIn
Follow Dr Nils Loewen on Social:
Nils Loewen | LinkedIn
Episode 13: ELIOS – What I learned from my first 100 cases? Part 1
In this first episode of the special two-episode series of the Interventional Glaucoma podcast, host Gok Ratnarajan is joined by esteemed guests Anselm Juenemann, Dan Lindfield, Jose Belda, and Nils
Episode 12: Captivating Cases: Reviewed by Prof Ike Ahmed
Prof. Ike Ahmed presents a series of ELIOS case studies recorded by Dr. Ana Miguel, Dr. Jose Belda, Dr. Karl Mercieca, and Ms. Nishani Amerasinghe.
Episode 11: Routine Phaco+ MIGS: Are we there yet?
Professor Gus Gazzard, Ms. Nishani Amerasinghe, and Dr Jose Belda discuss the concept of routine Phaco Plus.