Which is best for me?
The goal of glaucoma treatment at Eye Medical Clinic is to preserve your current level of vision and to prevent further vision loss. Treatment can vary, depending on the type of glaucoma diagnosed, the degree to which the glaucoma has progressed, your underlying risk factors and other variables. In general, prescription medicines (eye-drops and oral medications), laser procedures and operative procedures are all utilized in attempt to preserve vision.
For most patients with glaucoma, medication alone will be enough to control eye pressure. In some cases, several medications working together are necessary to maintain adequate pressure control. When medical treatment alone fails to sufficiently reduce the pressure, surgery is another option. Dr. Paik and Dr. Hadi have expertise in treating glaucoma, including the most current advances in minimally invasive glaucoma surgery (MIGS) procedures.
MLT/SLT is a form of laser surgery that is used to lower intraocular pressure in open-angle glaucoma. It is used when eye drop medications are not lowering the eye pressure enough or are causing unwanted side effects. It may sometimes be used as initial treatment in glaucoma.
MLT/SLT can be performed as an outpatient procedure at Eye Medical Clinic, has very little downtime and most patients report little to no discomfort. MLT/SLT has been in use for more than 20 years in the United States and around the world.
Laser peripheral iridotomy is a standard first-line treatment in closed angle glaucoma and eyes at risk for this condition. It has been used since 1984 both as treatment and for prevention of the disease.
The procedure creates a tiny hole in the outer edge of the iris, leading to an opening of the angle in the majority of cases. After the angle is widened from the procedure, the trabecular meshwork (which directs fluid out of the eye) is exposed and fluid outflow is enhanced.
CPC is a form of laser surgery that aims to lower your eye pressure by decreasing the eye’s fluid production. It is recommended for patients with refractory glaucoma who have persistent elevated eye pressure. Patients usually have failed tube shunt procedures or trabeculectomies. Other candidates for this procedure are patients with minimal useful vision or those who need pain relief.
New technologies and devices, known as MIGS, aim to lower the eye pressure in a much safer manner with rapid recovery and minimal restrictions. Instead of creating an artificial drain in the eye, they unclog the natural drainage system of the eye and enhance drainage.
The latest MIGS approaches include the iStent, Trabectome, Ab-interno Canaloplasty, CyPass and the XEN Gel Stent. There are several advantages offered by the MIGS procedures. They are minimally invasive, nonpenetrating procedures that do not create a permanent opening in the wall of the eye. This avoids the potential spectrum of sight-threatening complications associated with traditional glaucoma surgery.
Additionally, they can be performed either as stand-alone procedures or at the time of cataract surgery with similar recovery, postoperative drop regimen and restrictions of activity as cataract surgery alone. A large majority of patients can not only achieve independence from eye glasses but minimize or eliminate/minimize glaucoma eye drops.