Australian and New Zealand Glaucoma Society (ANZGS) Consensus on Interventional Glaucoma

Traditional reactive 'wait and see' approaches in glaucoma management often result in unacceptable rates of permanent vision loss. This consensus defines a proactive 'interventional glaucoma' framework tailored for the Australian and New Zealand healthcare context.

A modified Delphi consensus process was utilised, consisting of a lead panel of 12 experts (10 Australian, 1 New Zealand, and 1 Singaporean) and a validation cohort of 55 glaucoma specialists and ophthalmologists. Consensus was established via live panel presentations and real-time electronic polling. Participants evaluated statements using a three-tier scale: agree, stand aside, or object, with a pre-defined consensus threshold of an objection rate < 20%.

Twelve consensus statements were ratified. Key points include the formalised classification of glaucoma as a progressive optic neuropathy and the staging of disease to personalise target intraocular pressures to minimise progression. Selective laser trabeculoplasty and Minimally Invasive Glaucoma Surgery were recognised for their role in reducing the daily medication burden for mild-to-moderate disease. Traditional incisional surgeries remain the gold standard for advanced or refractory cases. The emerging role of Polygenic Risk Scores in adult-onset glaucoma was also acknowledged.

This Australian and New Zealand Glaucoma Society consensus on interventional glaucoma advocates for a shift towards an interventional paradigm. By utilising advanced diagnostics and timely procedural interventions, clinicians can better preserve visual function and optimise long-term patient quality of life.