Treatment Options

 

Laser Treatment Options

SLT (Selective Laser Trabeculoplasty)

Selective Laser Trabeculoplasty (SLT) is a safe and effective way to treat glaucoma. The laser works by opening up channels in the trabecular meshwork and utilizing the natural drainage system in the eye. It is an easy procedure done in our office and only takes minutes to do. Recovery time is typically rapid, with little to no discomfort.

MicroPulse® Laser Trabeculoplasty
With MicroPulse® laser therapy, a continuous-wave laser beam is broken down into a train of short, repetitive, low energy pulses separated by a brief resting period allowing the tissue to cool between laser pulses. This tissue-sparing laser therapy is used to reduce ocular pressure.

 

Surgical Treatment Options

Trabeculectomy

This classic glaucoma surgical procedure has been performed for many years.  This procedure is often recommended when reasonable efforts with medicine and laser have not been effective.

The treatment is performed in our surgery center and takes about an hour.  Trabeculectomy involves creating a small channel that allows the flow of fluid to “bypass” the trabecular network and lower intraocular pressure.  Recovery time generally takes anywhere from 1 – 6 weeks.

Glaucoma Tube Shunts

With this procedure, a small silicone tube is placed in the eye where fluid is drained to a “plate”where the fluid collects and then is re-absorbed into the body.  This technology continues to improve and is  an excellent procedure that can help control intraocular pressure and slow the progression of glaucoma.

iStent® with Cataract Surgery

iStent® is the smallest medical device ever approved by the FDA.  This tiny implant is placed in your eye during cataract surgery, and is so small, you will not be able to see or feel it after the procedure is complete.  iStent® works by creating a permanent opening in your trabecular meshwork, and works continuously to improve the outflow of fluid from your eyes to help control eye pressure.

ABiC™

ABiC™ (ab interno canaloplasty) is a new minimally invasive glaucoma surgery (MIGS). ABiC™ is unique in that it acts to restore the eye’s natural drainage system. ABiC™ addresses several aspects of outflow resistance including Schlemm’s canal and the Collector Channel System. The procedure utilizes a small cathater, iTrack, that is used to canulate the existing drainage pathway. Further information can be obtained at www.glaucoma-itrack.com/treatment-options.

Kahook Dual Blade® (KBD)

The Kahook Dual Blade® is a high-tech, single-use instrument that is used to treat glaucoma, typically performed at the time of cataract surgery.  This outpatient procedure is quick and painless, with quicker recovery than most other glaucoma treatments.  This technology allows our surgeons to treat glaucoma by making precise, targeted incisions in the eye’s trabecular meshwork tissue for quick and effective glaucoma treatment.

Gonioscopy Assisted Transluminal Trabeculectomy (GATT) with OMNI Device

GATT is a minimally invasive surgical treatment for the management of open angle glaucoma in both adults and children.  Dr. Dossey incorporates the OMNI device to carry out this two-part procedure.  The first part, visco-canaloplasty, is a procedure that dilates the entire 360 degrees of Schlemm’s canal, allowing drainage channels to function better.  The second part, trabeculectomy, removes a portion of the trabecular meshwork, providing direct access for fluid to drain into Schlemm’s canal.  Patients at any stage of glaucoma are candidates for this procedure.

Prevention is the Best Medicine
Vision loss from glaucoma is permanent but can usually be prevented with early detection and treatment. Glaucoma management can be a life-long process requiring frequent monitoring and constant treatment. Since there is no way to determine if glaucoma is under control based on how a person feels or their vision, they should be examined every 3 to 6 months.

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Medication Treatment Options

Medications are extremely safe and effective at treating glaucoma. Medications have multiple mechanisms of action, including slowing down the production of fluids, (turning down the faucet to a sink) or facilitating drainage of fluid from the eye (opening up the drain). The most popular and effective glaucoma medication classes include:

Prostaglandin Analogues

Examples:
Xalatan®    Lumigan®    Travatan Z®

These medications work by opening up outflow channels in the eye. They are extremely effective and are only taken one time a day (usually at night). All of these medications can cause red eye, make eye-lashes grow and rarely cause mild pigmentation around the eye.

Beta-Blockers

Examples:
Timolol®    Betimol®    Istalol®    Betagan®

These medications have been known to be effective in treating glaucoma for many years. They work by slowing down the production of fluid inside the eye. They are not used in asthmatics or other patients with reactive airway disease. They rarely exacerbate depression.

Carbonic Anhydrase Inhibitors (CAI)

Examples:
Azopt®    Trusopt®;

These medications work by slowing down the production of fluid inside the eye and bringing down the intraocular pressure. These medications work very effectively when combined with a prostaglandin analogue or a beta-blocker. They rarely have systemic side effects but can cause eye irritation on occasion.

These medications work by slowing down the production of fluid and increasing the outflow of fluid from the eye. These medications can occasionally cause an allergic conjunctivitis with a red eye.

Combination Medications

Examples:
Cosopt® (combination of CAI and beta-blocker)
Combigan® (combination of alpha agonist and beta-blocker)

These are effective and convenient medications that combine two separate medications in one bottle.

 

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