The Brazilian SUS will offer a combined surgical procedure to treat glaucoma and cataract simultaneously, approved by the Ministry of Health and validated by Conitec, with projected savings of R$22.4 million in the first year and R$276 million over five years.
The Brazilian Sistema Único de Saúde (SUS) has officially incorporated a surgical technique allowing the simultaneous treatment of glaucoma and cataract, marking a significant advancement in public healthcare. The procedure, approved by the Ministry of Health and endorsed by the Comissão Nacional de Incorporação de Tecnologias no SUS (Conitec), will be available for patients with mild to moderate primary open-angle glaucoma (GPAA) who also require cataract surgery. The technique, which involves either goniotomia excisional or trabeculotomia transluminal, aims to reduce surgical invasiveness, accelerate recovery, and lower long-term healthcare costs.
How the Procedure Works and Its Benefits
The new approach combines cataract removal with glaucoma management in a single intervention. During the surgery, the clouded lens is removed and replaced with an intraocular implant, while the eye’s drainage system is adjusted to lower intraocular pressure. Two methods are available: goniotomia excisional, which involves a small corneal incision to improve fluid drainage, and trabeculotomia transluminal, which uses a microcatheter to widen the natural drainage channel. Both techniques are less invasive than traditional procedures, according to the Ministry of Health, and may reduce the need for ongoing eye drops.
In addition to improving quality of life and treatment adherence, this innovation optimizes public resources and reinforces the SUS’s commitment to bringing the most advanced medicine to those who need it most,
said Fernanda De Negri, secretary of the Secretariat of Science, Technology and Innovation in Health (SCTIE). The procedure will be integrated into the Protocolo Clínico e Diretrizes Terapêuticas (PCDT) for glaucoma, ensuring standardized access across public hospitals.
Economic Impact and Cost Savings
Conitec’s analysis highlights significant financial benefits. The goniotomia excisional is projected to save approximately R$18 mil annually per patient compared to the iStent implant, with total savings of R$22.4 million in the first year and R$276 million over five years. These savings stem from reduced reliance on long-term medications and fewer repeat surgeries.
The Ministry of Health emphasized that the procedure will be prioritized for patients with GPAA, which accounts for 60% of glaucoma cases in Brazil. However, the exact implementation timeline and participating hospitals remain unspecified, as the agency has not yet announced rollout details.
Expert Perspectives and Patient Considerations
Patients with advanced glaucoma or closed-angle glaucoma (GPAF) may still require alternative treatments.
The transition to the new protocol will depend on hospital readiness and training, with no set deadline for full implementation.