Glaucoma is a disease defined as optic nerve damage. The primary cause of this nerve damage is elevated pressure inside the eye (intraocular pressure). Damage to the optic nerve can lead to progressive sight loss over the course of a patient’s life. Over the past several decades in the United States, the use of surgery as a stand-alone procedure for treating glaucoma has declined steadily. This is due to the fact that the medications (eyedrops) available to treat the disease have improved dramatically, while standard glaucoma surgeries are still considered to be high-risk for sight-threatening complications. The risks associated with some glaucoma surgeries, such as aqueous shunts or trabeculectomies, are often unacceptably high when compared to the risks associated with medical treatment.
MIGS or Micro-Invasive Glaucoma Surgery, is great treatment option for glaucoma patients who are considering cataract surgery. One such microstent, roughly the size of an eyelash, can be placed into the eye’s drainage system during cataract surgery. It acts as a kind of scaffolding that helps to open and enlarge the drainage system. In so doing, the stent helps to lower intraocular pressure. This innovative device is similar in form and fashion to the stents used for heart conditions such as coronary artery disease.
Because insertion of the device is done at the same time as cataract surgery, patients who need or want cataract surgery can have a combined cataract and glaucoma procedure. The cataract portion is performed to improve vision, and the microstent placement is performed to help control glaucoma. Insertion of the microstent generally adds only a few minutes to the surgery and is done when the cataract portion is completed. The microstent adds little overall risk to the procedure. Insertion of the microstent, however, can help greatly with the task of controlling eye pressure and thus controlling a patient’s glaucoma.
Most patients with both cataracts and glaucoma are considered to be good candidates for this combined procedure. The microstent provides patients with an opportunity to reduce the number of medications they use to manage their disease. It also provides the opportunity to improve eye pressure without being subjected to an ever-increasing number of topical medications (eyedrops), each of which can have side effects for both their eyes and other organs such as the heart and lungs.
We are fortunate at Barnet Dulaney Perkins Eye Center to have Dr. Neil Atodaria, a board-certified, fellowship-trained glaucoma expert who specializes in the management of cataracts in patients who also suffer from glaucoma. He has been performing glaucoma surgery for nearly a decade in Arizona. He is proficient in other glaucoma surgeries as well, and is on the cutting edge of improving existing procedures.
Dr. Atodaria and the other physicians and staff members at Barnet Dulaney Perkins Eye Center will be happy to provide information to any patient who is interested in this surgical option. For those not interested in the microstent, other combined procedures are available. For example, Dr. Atodaria can perform a laser procedure at the time of cataract surgery known as endocyclophotocoagulation (ECP). This procedure has been paired successfully with cataract surgery for nearly two decades and has been shown to be very effective.
Please ask your doctor or one of our scheduling team members for more information on combined cataract and glaucoma surgery.
Glaucoma is a term used to describe a group of eye conditions in which the optic nerve is damaged due to an increase in pressure within the eye. Left untreated, glaucoma often causes blindness. The best way to avoid the negative consequences of this disease is to undergo regular glaucoma examinations. Our practice, based in Phoenix, Arizona, has locations throughout the state where you can talk to an experienced optometrist or ophthalmologist and learn more about glaucoma treatment options.
Though all glaucoma is caused by increased pressure in the eye, different types of the condition can yield different symptoms and levels of severity. Below are descriptions of two of the most common types of glaucoma.
The most common type of glaucoma affecting our Phoenix, Arizona, patients is called chronic glaucoma, or primary open-angle glaucoma (POAG). In a normally operating eye, fluid called aqueous humor continually flows through the eye, eventually exiting through tissue known as the trabecular meshwork. In an eye affected by chronic glaucoma, this meshwork becomes blocked or clogged and fluid is unable to flow out of the eye. Intraocular pressure increases, pushing against the optic nerve and causing peripheral vision loss.
Angle-closure glaucoma, or narrow-angle glaucoma, occurs suddenly and presents symptoms such as headaches, eye pain, haloes around lights, and nausea. This type of the disease occurs when fluid in the eye is suddenly kept from draining properly due to blockage or over-dilated pupils. Though symptoms may disappear, it is essential that you seek medical treatment as soon as possible. Each renewed attack destroys more of your sight.
The most prevalent cause of glaucoma is age. It is estimated that one percent of Americans between the ages of 60 and 80 suffer from primary open-angle glaucoma; this number jumps to three percent in people over the age of 80. Ethnic background also plays a large role in glaucoma development. African-Americans have a high risk of developing glaucoma, as do people of Irish, Scandinavian, or Russian heritage.
Medical conditions such as extreme nearsightedness and diabetes have a hand in glaucoma risk. Our Phoenix, Arizona, doctors will also ask you about your medications during your examination, as certain inhaled or oral steroids may increase the chances of developing glaucoma.
If you are diagnosed with glaucoma at one of the Arizona locations of Barnet Dulaney Perkins Eye Center, we will attempt to control the disease with medications that either decrease the amount of fluid produced by the eye or increase the amount of fluid that drains from the eye. If these medications do not adequately treat your glaucoma, your doctor may suggest surgery to increase the drainage flow.