Glaucoma Summit Extreme – Pre-Event Questionnaire Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Section 1: About YouBefore the programme begins we would like to understand your current experience with glaucoma surgery and your expectations for the summit. Your input helps us fine-tune the experience and measure learning outcomes.NameOptional. Leave blank if you would rather answer anonymously.Institution / Clinic *Country *Years of experience in glaucoma surgery *<1 year1–3 years4–7 years8–15 years15+ yearsHow would you describe your current surgical focus in glaucoma? *Mainly MIGS proceduresTraditional filtering surgeryTube implantsMixedDiagnostic / medical glaucoma onlyOther / invites looking If you chose Other, please specifySection 2: Current Use of Devices & TechniquesPlease indicate how familiar and experienced you are with each of the following devices and surgical techniques.XEN (Abbvie)I don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Preserflo (Santen)I don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)TrabeculectomyI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Paul Implant / Ahmed / BaerveldtI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Kahook Dual BladeI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)iTrack (Nova Eye)I don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Hydrus (Alcon)I don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)OMNI Surgical SystemI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Intercil (Ciliatech)I don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Miniject (iStar)I don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)iStentI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Deep SclerectomyI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)GATTI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)CanaloplastyI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Gonioscopy / Angle Surgery BasicsI don't know this device (1)I know it but haven't used it (2)I have used it occasionally (3)I use it regularly (4)Section 3: Expectations & GoalsWhat are your main learning goals for attending the Glaucoma Summit Extreme? *Learn about new surgical techniquesImprove skills in wetlabsExchange experiences with peersHear expert perspectivesOtherTick all that apply.If you chose Other, please specifyWhich session are you most looking forward to? Why?Is there a specific question or challenge you hope to address during the summit?Are you planning to implement a new device or technique in your practice after the event? *YesNoNot sure yetIf yes, which one?Section 4: Future EngagementEntirely optional — you can submit the form without answering this section.Would you be interested in participating in follow-up surveys after the event?YesNoWould you be interested in receiving early invites to future glaucoma events?YesNoWould you be interested in speaking or teaching at future MTS events?YesNoEmail addressOnly needed if you answered Yes to any of the three questions above, so we can contact you. We will not use it for anything else.EmailSubmit
