Objective:

To analyze the growth trends of micro-invasive glaucoma surgery (MIGS) within Part B Medicare, focusing on specific regulatory changes such as local coverage determinations (LCDs) and their impact.

Key Findings:

• MIGS procedures surged after FDA approval of iStent in 2012, peaking over 100,000 surgeries in 2019, indicating a significant market shift.
• A proposed LCD in 2023 is expected to slow the growth rate of MIGS procedures, raising concerns among practitioners.
• New technologies like direct selective laser trabeculoplasty (DSLT) and multifocal pupillographic objective perimetry (mfPOP) may enhance glaucoma care and offset regulatory impacts.

Interpretation:

While the growth of MIGS is likely to slow due to increased regulatory scrutiny, the demand for these procedures remains high, suggesting a potential shift towards alternative glaucoma treatments.

Limitations:

• The analysis is based on historical data, which may not fully predict future trends, particularly in a rapidly evolving healthcare landscape.
• The impact of the COVID-19 pandemic on procedure rates may skew data interpretation, necessitating caution in conclusions drawn.

Conclusion:

MIGS is expected to continue growing, albeit at a reduced rate, with potential increases in complementary glaucoma services due to new technologies and regulatory changes that may reshape the treatment landscape.