By Aly Sheraly, M.D. Board Certified Ophthalmologist Glaucoma Specialist
January is Glaucoma Awareness month. Over 2 million Americans are affected by glaucoma. With proper treatment, the vast majority will not go blind from this silent disease of the eye. The most common form of treatment is eye drops. These drops are very important and work to reduce the eye’s pressure, thus reducing the risk of glaucoma damage. For the vast majority, eye drops are sufficient for controlling the eye pressure.
However, there is a small minority that may require eye surgery to achieve their treatment goals. In the past, there were only a few glaucoma treatment surgeries available to help patients. These surgeries were often very extensive and had many complications. As time has passed and our understanding of glaucoma has progressed, new advances in surgical techniques and devices are available for patients that reduce their complication rates.
In this post, we review some of the newer surgical techniques collectively called Minimally Invasive Glaucoma Surgery (MIGS). These surgeries are primarily targeted towards patients with a specific form of glaucoma called Open Angle Glaucoma. About 90% of glaucoma patients in the U.S. have the Open Angle Glaucoma form.
iStent
This medical device was FDA approved in 2012 for implantation in the eye during cataract surgery in glaucoma patients. It is a small metal snorkel that is placed in the eye’s natural drainage tube to create a wider opening so more fluid can leave the eye. This extra outflow of fluid helps to lower the eye’s pressure. It has very few complications and many are self-limiting. When it is implanted in the eye, it remains permanently. In many patients, it is able to reduce the eye’s pressure. Some patients are even able to stop using their glaucoma eye drops.
CyPass
This medical device was FDA approved in 2016 for implantation in the eye during cataract surgery in glaucoma patients. It is a long narrow polymer tube that is placed in the eye in a space called the suprachoroidal space. It is a more sophisticated way of getting fluid from inside the eye to drain into the bloodstream more quickly. This also allows the eye pressure to go lower. It has very few complications, but there are reported cases of the eye pressure going too low, rarely causing reduction in vision. When the eye pressure goes too low, it is called hypotony. Most patients get good eye pressure control right after the surgery and are able to stop their glaucoma drops.
Overall
These newer MIGS procedures are a very exciting advance in the field of glaucoma. They are helping patients control their eye pressures and also reducing their dependence on eye medications. While they are still relatively new they are showing promise to potentially reduce the progression of glaucoma damage. There are many criteria to consider when deciding if a glaucoma procedure like the iStent or CyPass at the time of cataract surgery are indicated, so be sure to have your doctor review them with you.
At Eye Specialists of Mid-Florida, our mission is to use the latest technology available to help improve eye conditions like glaucoma. If you have glaucoma concerns, be sure to schedule an appointment with one of our eye doctors for an examination and recommendations. Patients with a family history of glaucoma need yearly eye exams.
