Under what circumstances would CPC be considered the primary intervention for severe glaucoma with preserved central vision?

I would consider CPC as a primary intervention in the following circumstances: old age (>80), no social support, inability to keep appointments, unable to instill glaucoma drops, or intolerance to systemic CAIs.

Karanjit

Only for someone who is a poor surgical candidate, despite best efforts at home, IOP cannot be controlled on drops, and likely to live long enough to suffer vision loss.

We don't place IVs for many MIGS (Kahook, iStents, idose, sometimes xen), all topical anesthesia. As a result, no pre-op clearance...