When Is Surgery Necessary?
When medications or laser treatment cannot lower eye pressure caused by glaucoma, surgery is usually recommended. Of the possible procedures, glaucoma filtration surgery using the iStent trabecular shunt, is a preferred treatment that Dr. Hunt performs. Currently, the iStent procedure is approved only when implanted at the same time cataract surgery is performed.
iStent Trabecular Shunt
The iStent works like the stents used to prevent heart attacks and strokes. When blood vessels get clogged, a stent creates access to the vessel flow. While a highly innovative technology, how the iStent works is elegantly simple:
What will my vision be like?
It's important to understand that surgery cannot recover vision already lost from glaucoma. The combination of the cataract/iStent procedure can restore vision that is diminished due to the cataract, and aims to preserve that vision by keeping eye pressure under control with the iStent.
Are there alternatives to iStent filtration surgery?
Yes, depending on the type and severity of glaucoma you have and how much the pressure needs to be lowered to halt its progression, a additional laser procedures can be performed such as SLT (selective laser trabeculoplasty) and ECP (endoscopic cyclophotocoagulation). SLT laser treatments are performed in the office, while ECP is performed during cataract surgery.
ECP (endoscopic cyclophotocoagulation)
When attempts to increase the amount of fluid draining from the eye through the trabecular meshwork fail, reducing the amount of fluid entering the eye is another option. Cyclophotocoagulation is a procedure that uses a laser beam to treat parts of the ciliary body, located behind where the clear cornea meets the while of the eye. The ciliary body produces the aqueous humor. The destruction of parts of the ciliary body reduces production of this fluid, lowering eye pressure. Cyclophotocoagulation is generally used to treat advanced or aggressive open-angle glaucoma and is usually used after other treatments have proven unsuccessful. The procedure, performed with a local anesthetic, can be painful postoperatively and medications for pain and inflammation may be necessary. Your ophthalmologist checks for inflammation and monitors the intraocular pressure in follow-up exams. Risks associated with Cyclophotocoagulation include pain, inflammation and decreased vision for one to six weeks after the procedure. While the risks may sound unpleasant, people with severe glaucoma must reduce intraocular pressure or risk losing vision permanently.
Loss Of Vision Can Be Prevented
Vision loss from glaucoma can be prevented if it is caught and treated in time. While glaucoma treatments cannot restore vision already lost from glaucoma, early detection and treatment of glaucoma offers the best chance of preserving vision.