Glaucoma Surgery
The iStent trabecular microbypass stent is a titanium stent placed into an area of the eye called Schlemm’s Canal. Placement of these stents can be performed through a corneal incision less than 3 mm. An injector is used to pierce the membrane overlying the eye’s drainage system (called the trabecular meshwork) and deploy up to three stents. It is safe to have an MRI with an iStent in your eye. This procedure can be performed alone or in conjunction with cataract surgery.
The Hydrus microstent is made of a nickel-titanium alloy and is inserted into an area of the eye’s drainage system called Schlemm’s canal, allowing fluid to leave your eye. It is safe to have an MRI with a Hydrus stent. This procedure can be performed through a corneal incision less than 3 mm and is done in conjunction with cataract surgery.
A goniotomy utilizes a microblade to make an incision in a part of your eye’s drainage system called the trabecular meshwork. This will allow fluid to leave your eye and thereby lower your eye pressure. This procedure can be performed through a corneal incision less than 3 mm and can be done alone or in conjunction with cataract surgery.
This gelatin implant is implanted in the white part of the eye called the sclera. Fluid leaves the eye through the stent and thereby lower your eye pressure. This stent is covered by the outer layer of the eye, called the conjunctiva. The fluid collects under your conjunctiva in a structure called a bleb, which is hidden under your eyelid. It is then absorbed into your bloodstream. Anti-scarring medication is used at the time of surgery to keep scar tissue from forming around the stent. If scar tissue blocks the stent after surgery, you may require an injection of more anti-scarring medication or a surgery to fix the bleb so fluid flows freely again.
Canaloplasty/trabeculotomy can be performed through a corneal incision less than 3 mm. This procedure involves threading a catheter through a part of the eye’s drainage system called Schlemm’s canal. A sterile gel is then released from this catheter to inflate and stretch parts of your eye’s drainage system (the trabecular meshwork, Schlemm’s Canal, and collector channels). Using the same device, your ophthalmologist will cut through the trabecular meshwork to improve drainage as well. This procedure can be performed alone or in conjunction with cataract surgery.
CPC diode is recommended for patients with refractory glaucoma to reduce aqueous humor secretion and lower eye pressure by lasering the secretory epithelium of the ciliary body. CPC is recommended for patients for whom a prior surgery is no longer functioning, or patients who are not ideal candidates for an incisional surgery.
This device consists of a tube connected to a plate and is made of a soft biocompatible material. The plate is sutured down to the white part of the eye, called the sclera, and the tube is inserted into the front chamber of the eye, called the anterior chamber. The tube acts to drain a clear fluid, called aqueous, out of the eye. The plate provides a reservoir for the fluid which has drained out of the eye through the tubing. From the reservoir, fluid is absorbed back into the circulation. The plate is situated far back in the eye, underneath the eyelid, and is covered by the outer layer of the eye, called the conjunctiva. Neither part, the tube nor the plate, is visible to a casual observer. With the upper lid retracted, a clear or white patch may be noted. This is a patch graft that covers the tube and prevents irritation and/or erosion of the implant. With all drainage implants, it can take 3 months or longer after surgery for the intraocular pressure to stabilize, as the capsule surrounding the plate of the implant needs time to mature in the eye.
In this procedure a new drainage canal, or filter, is surgically created for the eye. The internal eye fluid drains through the filtering site, or window, and collects into a tissue pocket underneath the upper eyelid. The fluid filled reservoir is called a bleb. The fluid is then absorbed into tiny blood vessels and returned into the body’s circulation.
A trabeculectomy involves removing a small piece of tissue from the eye where the white part of the eye, called the sclera, meets the clear part of the eye, called the cornea. This opening, or window, allows fluid to pass more freely out of the eye. A small flap of scleral tissue covers the opening and is sutured into place. This acts as a trapdoor. It can be adjusted to allow more or less fluid to pass through the opening. The doctor adjusts the amount of flow by cutting the stitches postoperatively. When the fluid drains out of the eye, it flows into a tissue pocket reservoir underneath the upper eyelid. This is created by the surgeon at the time of the surgery.