At the 2025 American Academy of Ophthalmology meeting, glaucoma experts shared exciting advancements pointing toward a future with safer procedures, more predictable pressure control, and increasingly personalized treatment options. Presentations from Dr. Inder Paul Singh, Dr. Sahar Bedrood, and Dr. John Berdahl highlighted how innovations in drug delivery, surgical visualization, and cataract planning are reshaping patient care.*

1. Long-Lasting, Drop-Free Pressure Control With iDose + Cataract Surgery

Presented by: Dr. Inder Paul Singh

Dr. Singh’s talk focused on the iDose implant, a tiny device that releases a prostaglandin medication from inside the eye during cataract surgery, helping many patients reduce or eliminate daily glaucoma drops.

Key Takeaways

• Patients started with an average eye pressure of 25 mm Hg (off drops).
• After 12 months, pressure dropped by 11 mm Hg, and nearly all patients saw at least a 20% reduction.
• Over 96% maintained pressures below 18 mm Hg, a key safety threshold.
• Most remained completely drop-free, which may help those who struggle with adherence, side effects, or cost.

Dr. Singh emphasized that the safety profile has been excellent. He reported no significant swelling or inflammation, and no extra postoperative steroids were needed.

Why This Matters

For many patients, the iDose implant may offer:

• long-lasting pressure control
• fewer medications
• easier routines
• less irritation to the eye’s surface

Because the implant is placed during cataract surgery and doesn’t require advanced angle surgery skills, Dr. Singh believes more surgeons will be able to offer it in the future.

2. A New Era of Surgical Precision With the Leos Endoscopic Laser System

Presented by: Dr. Sahar Bedrood

Dr. Bedrood showcased a major leap in visualization technology for endoscopic cyclophotocoagulation (ECP), a laser treatment that targets the ciliary body to help lower eye pressure.

Her reaction to the new Leos endoscopic laser system was simple: “I’ve never seen the ciliary body so clearly.”

What’s New

The Leos system provides:

• sharp, high-resolution images
• improved depth perception
• clearer views of delicate anatomy
• single-use handpieces to ensure consistent image quality

This level of detail let Dr. Bedrood use lower energy while maintaining strong pressure-lowering results, potentially reducing inflammation and improving comfort.

OR staff praised the device’s straightforward design (“one button, one click”), which made it easier to use than older endoscopes.

Why This Matters

Better visualization means:

• safer laser application
• fewer complications
• more reliable results
• a smoother surgical workflow

For patients needing ECP, this could translate to a safer, more predictable pressure-lowering experience.

3. Personalized Cataract Lens Choices for Pseudoexfoliation Patients

Presented by: Dr. John Berdahl

Dr. Berdahl focused on patients who have both glaucoma and pseudoexfoliation (PXF), a condition that weakens the eye’s internal support system. These patients often need cataract surgery, but lens selection can be more complicated.

Dr. Berdahl’s Key Advice

• The capsular bag must be stable, often requiring capsular tension rings.
• Pupil behavior must be evaluated before considering certain advanced lenses.
• Future needs (like lens repositioning) should be part of the plan.
• Lens choice should match the severity of glaucoma, especially when contrast sensitivity is affected.

Multifocal and extended-depth-of-focus lenses can work for mild glaucoma but may not be ideal for moderate disease, where contrast loss is more pronounced. Toric lenses, however, remain safe and effective.

Why This Matters

For PXF patients, lens decisions aren’t one-size-fits-all. Dr. Berdahl reinforced that individualized planning is essential for maintaining good long-term vision.

The Big Picture: Where Glaucoma Care Is Heading

Across these presentations, three major themes emerged:

1. More Drop-Free Treatment Options

Sustained-release implants like iDose are making long-term pressure control easier and more reliable.

2. Greater Surgical Precision

New visualization tools are helping surgeons perform safer, more targeted procedures.

3. Personalized Care Plans

From laser therapy to cataract lens selection, treatment is becoming more tailored to each patient’s anatomy, diagnosis, and long-term visual needs.

Together, these innovations point to a future where glaucoma care is more predictable, more personalized, and more patient-friendly than ever before.

* Ophthalmology Times (November 26, 2025). “AAO 2025 Takeaways: The new era of glaucoma treatment and surgical precision” ophthalmologytimes.com

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