What glaucoma treatment options are there after medication resources have been exhausted?
If intraocular pressure cannot be adequately controlled with oral or topical medications, glaucoma surgery may be needed. These are all outpatient procedures most commonly performed under monitored anesthesia care using a local block or anesthesia.
Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye’s trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed by the adjacent structures.
Tube Shunt Surgery
At OCLI, we can use a device known as a shunt or tube shunt to lower intraocular pressure. Tube-shunt surgery involves placing a flexible plastic tube with an attached silicone drainage device in the eye to help drain intraocular fluid or aqueous humor, from the eye. This type of surgery can be performed if a trabeculectomy failed, or if a person already has or is likely to form scar tissue in the eye, this type of surgery may be done at the start.
Endoscopic CycloPhotocoagulation (ECP)
Endoscopic CycloPhotocoagulation (ECP) is a laser procedure performed at the same time or after cataract surgery for the management of glaucoma. Endoscopic CycloPhotocoagulation has proven to be highly effective in reducing or eliminating the need to continue using glaucoma medications in the majority of patients who receive this treatment. Studies have shown that the ECP procedure has significant success rate with a relatively low complication risk.
iStent is a microscopic stent that creates a permanent tunnel for fluid drainage. It helps to relieve pressure in the eye and treat glaucoma-related vision loss. The stent is implanted during cataract surgery. Many people with glaucoma also suffer from cataracts. Because cataract surgery is a stitch-less procedure, the stent is implanted without any cuts or incisions.
iStent is the first MIGS device that improves your eye’s natural fluid outflow to safely lower eye pressure by creating a permanent opening in the trabecular meshwork.
“Glaucoma is often controlled with eye drops, which can very burdensome to patients. By using the iStent we have a solution to reduce a patient’s dependency on glaucoma eye drop medication following cataract surgery”. – Dr. Caronia
ABiC™ – An effective MIGS procedure for Glaucoma Treatment
The Evolution of Canaloplasty
The latest evolution in Canaloplasty is ABiC™, a subtle but significant refinement of traditional (ab-externo) Canaloplasty. ABiC™ follows the same dilation principles of traditional Canaloplasty, but with the speed and efficiency of a minimally invasive procedure. Performed via a self-sealing, clear corneal incision, ABiC™ can be combined with cataract surgery, or as a stand-alone procedure.
Goniotomy – Kahook Dual Blade™
Goniotomy is a surgical procedure in which the doctor uses a lens called a goniolens to see the structures of the front part of the eye (anterior chamber). An opening is made in the trabecular meshwork, the group of tiny canals located in the drainage angle, where fluid leaves the eye.
The Kahook Dual Blade (KDB) is the newest iteration of this procedure. It is an elegant device that has a micro-engineered profile, which allows for insertion into the eye through a clear cornea micro incision. This can be performed in conjunction with cataract surgery.