This week’s blog on Glaucoma has been contributed by Dr Mohammed Sohaib Mustafa, Consultant Ophthalmic Surgeon, Specialist in Glaucoma and Cataract Surgery
Glaucoma is a chronic eye disease in which increased pressure in the eye can lead to damage of the optic nerve resulting in gradual loss of vision – in fact, it accounts for more cases of irreversible blindness than any other eye disease. The good news is that it can be treated effectively through medication although some patients may still need surgery.
There is a range of new surgical techniques that can be used to reduce the pressure within the eye and help stop or slow any progression of the glaucoma and so preserve vision. These new techniques help minimise any risks associated with Trabeculectomy surgery.
Glaucoma drainage device
Glaucoma drainage devices are an alternative to surgical procedures for glaucoma. In a recent large clinical study, Baerveldt Tube Surgery was shown to be superior to Ahmed Tube Surgery, with excellent long term results. Dr. Mustafa is the only surgeon in the UAE who performs the Baerveldt tube procedure.
Selective Laser Trabeculoplasty
Selective Laser Trabeculoplasty or SLT is a laser treatment for glaucoma. Glaucoma is often caused by raised pressure within the eye caused by poor drainage of fluid through the eye’s drainage channels (trabecular meshwork). With SLT, a laser is used to improve drainage. It is a quick and painless outpatient procedure and can be used as a first line treatment option.
Micropulse laser is an alternative laser procedure that aims to reduce the amount of fluid that the eye produces and thereby lower eye pressure. This procedure can now be used in all cases of glaucoma, including the most severe.
A peripheral iridotomy or PI is a laser treatment for people with, or at risk of, a type of glaucoma known as angle closure glaucoma. The angle is the part inside the eye where the fluid (intraocular fluid) drains. If the angle is narrow or closed then fluid cannot drain and there can be a build up of pressure in the eye, causing damage. A narrow angle is usually detected during a routine examination and most people who need a PI will have no symptoms.
A small 1mm mesh tube made from titanium (known as an iStent) can be surgically inserted to help the eye’s natural ability to drain fluid and so reduce pressure inside the eye. This minimally invasive glaucoma surgery (MIGS) is safe and results in patients not having to use eye drops every day.
Xen Gel Stent
Another MIGS procedure is the insertion of a Xen Gel Stent that also reduces pressure inside the eye by draining fluid via a tube (stent) connecting the anterior chamber of the eye to a bleb (or reservoir) positioned below the conjunctiva.