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Assessing the significance of the IRIS Registry wide-scale MIGS study

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A recent study released by Sight Sciences, Inc and Verana Health offers further data for surgeons looking to tailor treatments to glaucoma patients, especially those for whom lightening medication load is crucial.

The data was presented by Michael Mbagwu, MD, Adjunct Clinical Instructor of Ophthalmology at Stanford University School of Medicine and Senior Medical Director at Verana Health, during the 2023 American Society of Cataract and Refractive Surgery (ASCRS) annual meeting, where it won for best presentation.

Dr. Mbagwu sat down with Glance to discuss the implications of this study on patients and future research.

What is the IRIS Registry?

The Intelligent Research In Sight (IRIS) Registry is the American Academy of Ophthalmology’s AAO’s comprehensive eye disease and condition registry.

Launched in 2014 and managed in partnership with Verana Health, the registry has collected data from more that 75 million patients over 454 million visits, as well as over 16,000 eyecare practitioners across the United States.

Tell me again about the study.

The study assessed the medical records of 16,789 patients with mild-stage glaucoma and found that patients who received MIGS surgery enabled by the OMNI Surgical System in combination with cataract surgery experienced the highest average medication reduction (mean reduction from baseline of 1.01 glaucoma medications at 12-months, postop).

For the full recap, read our story here.

What are the implications of this data for surgeons and patients?

There are two main groups of patients for whom this kind of data is crucial, explained Dr. Mbagwu.

The first is patients for whom medications don’t work as well to lower intraocular pressure (IOP); the second is patients for whom medications would be an option, but instillation is difficult.

Give me a real-world example.

One of Dr. Mbagwu’s patients in this latter category is a veteran with Alzheimer’s disease who experiences sundowning.

“When the day changes from day to night, he gets very confused and agitated. It’s difficult for him to actually recognize who’s around him,” Dr. Mbagwu said. “Getting eye drops into his eyes—it’s a very [scary] thing for somebody who might have a cognitive impairment and not understand what is going on.”

And the overarching effect?

Reducing the medication burden on patients can have wide-ranging implications for mental and physical well-being as well as compliance.

“Our study showed we can meaningfully reduce the medication burden for people,” said Dr. Mbagwu. “This really, for me, is the most significant part.”

What implications are there for future research?

“We can show [that MIGS reduces the medication burden on patients] using pharmacy claims data, and our study is not just a single site,” explained Dr. Mbagwu. “That data's important, but we have a registry with 16,000 contributing clinicians and over 500 million patient visits.”

Of note, the final study cohort included 24,676 unique patients.

Many procedures have a shared CPT code, but the IRIS Registry includes more detailed data, such as which precise procedure or device was used. Because of that, Dr. Mbagwu explained, researchers can further segment their cohorts and algorithms to explore very specific trends.

Take away.

The IRIS Registry and similar projects have immense potential for future research through massive collections of real-world data.

“I hope that this and other research like it can be provocative and thought-provoking because I want the best options for the patients that I see, whatever those options are,” stated Dr. Mbagwu.