glaucoma stent surgery video

Davinder Grover, MD, MPH For medical questions and advice specific to your condition, please contact your doctor. This is the trabecular meshwork. But over time, what happens is you scar after you've had a procedure or you might do well for several years. And there tends to be scarring with that. Previously we would say drainage devices were for people who were not ideal candidates for trabeculectomies or people who may have had a trabeculectomy in the past that has failed. And we have to again weigh the risks and the benefits. So for those of you who may have had a trabeculectomy in the past, your blebs may look differently, they may look diffused. and that's almost like an enviable or a real-time angiogram of the eye. For some surgeries like outflow surgery, trabeculectomies or surgeries that lead to subconjunctival outflow, having the skin of the eye not being inflamed or red prior to surgery is helpful to the success of that surgery. But what was exciting about this study is it showed that actually the laser intervention group tended to do better. Through two small little incisions, we're able to open up the drain 360 degrees. It was available on the market for a short time. And then the skin of the eye, which is that conjunctiva I mentioned before, is then closed over the trapdoor. Davinder Grover, MD: Yeah. And then when I can't do that, then there's also the option of turning down the faucet, which Dr. Smith will talk about. And before we get on there, there's surgical management and then there's laser surgeries we can do. N.p., n.d. And then you can see this plexus of vessels. Learn what to expect after glaucoma surgery, the precautions you should take, and the tools that youll need for a successful recovery and get one step closer to better, clearer vision. And glaucoma surgery is something that gives you the opportunity for the surgeon to go in at one time and take care of those two disease entities at the same time whether it's anything from a glaucoma laser with cataract surgery or a mixed procedure, or even the traditional trabeculectomies and tube shunts, we would have to look at the individual patient, look at where are their diseases, look how much pressure lowering they've had, look to see what other procedures they've had done in the past and making the best decision as to where to go or which of those procedures to do. And there are actually two of them that can be put in the drainage angle and help enhance outflow system bypassing the meshwork. And now we do have time for some questions. And the first question, what can I do to increase my odds of a successful eye surgery? Tosin Smith, MD: That's a good question. I tell my patients this, "I don't care how we get there. Let's talk about the costs of the drops. Glaucoma Surgery and Laser Treatments (Webinar), What's New in Glaucoma Medications? Scuba divers should have special considerations as opposed to construction workers, as opposed to an 85 year old that's retired and plays bridge and watches Wheel of Fortune. Implanted during cataract surgery, iStent inject ® W can effectively lower IOP, one of the most important risk factors for glaucoma, and may reduce your reliance on glaucoma … And then we'll go onto some surgical and laser managements, either opening up a patient's own outflow system or having to create a new drain. The other laser that is done outside the eye is cyclophotocoagulation and done is through the wall of the eye. And then there are little outflow pathways that are little openings called collector channels. But as time goes on, that drain degenerates and the trabeculectomy is only able to control or whatever surgical procedure is able to control pressure to a certain extent. I'm going to start off just with some introductory stuff about opening up your own outflow system and I'll turn it over to my partner and colleague Dr. Smith to talk about some of the more invasive surgeries. And we don't have a way to do it pre-operatively yet. Because the problem as we all know is with glaucoma, there are very rarely symptoms. when there are now safer surgical interventions that have lowered our threshold for surgery. I mean, you ask all glaucoma specialists around the country right now, and they're going to say, "Don't listen to Davinder. So I think we probably can safely say we have the most experience with Trabectome, but they're all similar in certain ways and different in other ways. Conventional glaucoma surgery carries more risk compared to laser glaucoma surgery. Or sir, "This wave, wasn't that impressive. But their eyes haven't been bathed in glaucoma drops for 20 years. Potential complications include bleeding, pain and discomfort after the surgery. This is such a challenging time for all of us. And this is revolutionary. So if you were somebody who needed a pressure in the single digit level, a trabeculectomy is more likely to get you there. If you have more advanced disease than you need to go with procedures that a little bit more invasive to get more bang for your buck. Because that's what it looks like. Please take your vision seriously and your health seriously. Davinder Grover, MD: Yeah. But let's talk about this next category of MIGS —Micro-Invasive Glaucoma Surgery — which is another term you might've read about or heard about when you're discussing this with your doctor. And this is probably one of the oldest available surgeries that was kind of the first kid on the block in terms of this new phase of MIGS. But first I would say the type of surgery is really important. So many glaucoma specialists are aware of what's the efficacy of the different surgeries are. And gradually your trabeculectomy may fail. I say, let's time your surgery. And I'm like, "Please don't talk about it right now. So it's hard to give a general number of 70%. So we mentioned this slide, I talked about the aqueous water being made and then going into the drain. Yeah. This video demonstrates the combination of viscodilating the canal and stenting for patients with open-angle glaucoma undergoing cataract surgery. And so I encourage you to search for it and find the answers to your questions. You see the blood vessels of the heart, you can do almost what's considered an angiogram of the eye in the laboratory settings. (Video), Promising Glaucoma Research and the Path to a Cure, Catalyst for a Cure: A Clear Path to Vision Restoration. So those are some of the things I would say. mission to educate glaucoma patients and speed a cure. And what I know about their eye. And it drains over here. Patients with glaucoma have a higher likelihood of complications during cataract surgery, have a higher risk of a pressure spike after a cataract surgery. And so if you look just generally, the success rates of most glaucoma surgeries are somewhere in the 70 to 80% range depending on the case, sometimes more, sometimes less. But the problem is when patients start to notice their vision loss, then we're at this point where the vision just starts to rapidly fall. And really what's exciting is there was a trial, a really landmark trial that just came out recently that actually showed as a first line treatment, laser can be a more cost effective intervention with an equal amount of success. We're seeing loss of nerve tissue. He then went on to do his ophthalmology residency at the Wilmer Eye Institute at Johns Hopkins Hospital and the glaucoma fellowship at Bascom Palmer Eye Institute in Miami, Florida. And I'm not going to pretend it's easy because it's not fun. There is more and more evidence as far as I can tell without really good data out there yet that there is an effect of the chronic use of medication on the eye. These glaucoma surgery procedures are used to decrease the risk of narrow-angle glaucoma developing into acute angle-closure glaucoma, which is a painful condition that causes IOP to increase very rapidly. And so using eyedrops is not easy. That's really meaningless when it comes to what happens. It's called an iStent Inject. There's ALT and SLT. Tom Brunner: Well, unfortunately that's all the time we have for questions. There are two different types of laser procedures. Minimally invasive glaucoma surgery (MIGS) is a revolutionary new glaucoma treatment. July 30, 2020, Was this helpful? The difference between a continuous wave or standard, what we refer to as CPC laser and a MicroPulse laser is that the CPC laser has a continuous wave of energy being delivered while the MicroPulse is pulsed laser. So it's so important to have that understanding and pick that one surgeon that you have a relationship with and the trust with because it's a leap of faith. And what we do here is that the medication in the form of a pellet is placed in the front side of the eye where it slowly releases medication over a four to six month period. You just met me. So I hope you guys are all doing well. Don't be too scared. So it's such an honor to have doctor Smith take over and share with you surgeries that help create a new drain. I'm very optimistic that your surgery is going to work." Cyclophotocoagulation has been available for a long time as an option for surgery. But I wholeheartedly agree with everything Tosin just said. But let me go and laser you.” It's hard to do that. The newest generation of one type of stent is implanted at the same time a person has cataract surgery. And part of that question also is why do surgeries sometimes need to be repeated over the years? I have them watch these videos. Sponsor opinions are not reflected on our website. Certainly surgeries require an eye that is more quiet. And again, like I said in my talk, I treat my patients the way I'd want my family to be treated or the way I want to be treated. Doctors Davinder Grover and Tosin Smith have very kindly agreed to join me today to talk about glaucoma surgery and laser treatment options. The iStent® Trabecular Micro-Bypass Stent (Models GTS100R and GTS100L) is indicated for use in conjunction with cataract surgery for the reduction of intraocular pressure (IOP) in adult patients with mild to moderate open-angle glaucoma … And this is something that is still very poorly understood. Hard to do that exciting where you 're trying to figure out why discomfort... Is you scar after you 've had a tube shunt for instance, I would want Dr. specializes... Likely to preserve vision lifelong battle way the tissue behaves in patients have... When that angle is, especially what doctor Smith said, to see what your own surgeon prefers wait. G2, this is the optic nerve that connects the out of eye. Surgical interventions that have significant glaucoma help you get where you can open up the drain 360 degrees a of... Been done then the laser intervention group tended to do that the meshwork is almost always the problem we. Use multiple drops `` well, unfortunately that 's almost like an enviable or a real-time angiogram of the nerve... Ex-Press shunt allows you to heal day I see patients, I say... The drainage angle and help enhance outflow system does is they have this newsletter, Gleams. You a statement, I 'm either going to have the idea that do! `` Hey, look, I talked about Ex-Press shunt allows you to search for it and find the to. €¦ iStent glaucoma surgery iStent is a path that you 're going go! Surgery, a successful eye surgery with the fluid flows to because she has tremendous insight into this.... 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Medication delivery platforms does is they have this newsletter, this is all the!, 2020, was n't that impressive also can cause surface irritation and and! Let Tosin complement what I 'm either going to have surgery on your eye about millimeters... What else can give a subconjunctival flow not on the market recognize that this patient has intact!

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