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What is Glaucoma

Glaucoma is a progressive, blinding disease that is unfortunately, common in the United States. Approximately, 50% of patients with glaucoma do not know they have the disease. Approximately, 20% of patients with cataracts, also have glaucoma. The treatment options for glaucoma have been limited in the past. To treat glaucoma, we used eye drops. We would often start with one eye drop. If that was not enough, we would add more eye drops to be used multiple times per day. In the past, some patients would have to use four separate eye drops up to three times per day. After these drops failed, we would consider laser surgery for glaucoma. If laser surgery failed, the only other option for progressive glaucoma was end-stage “cutting” glaucoma surgery.  End-stage glaucoma surgery was a last-resort. These surgeries were risky, and often had multiple side effects, including vision loss!

The treatment for glaucoma has changed significantly in the last few years! Instead of starting patients on eye drops, we can now do laser surgery. This surgery is called laser trabeculoplasty. The most common laser trabeculoplasty used today is called Selective Laser Trabeculoplasty (SLT). This treatment is a virtually pain free, 20 minute procedure performed in the ophthalmologist’s office. There are no restrictions before or after the procedure. Furthermore, the procedure is very safe with very few side effects. At Metrolina Eye Associates, our philosophy for treating glaucoma has changed with advancements in science and technology. We now offer Selective Laser Trabeculoplasty, or glaucoma laser, as a first-line treatment for glaucoma, instead of eye drops. We have come to recognize that eye drops are a hassle, they can be expensive with monthly co-pays, and most off all the may cause side-effects such as dry or irritated eyes, breathing problems, or even passing out. At Metrolina Eye Associates, we now can treat glaucoma once with laser trabeculoplasty with an effect that lasts at least one year. That means we can treat each eye just once a year and drops may be eliminated! The laser is not successful in everyone, but 75%-80% of patients have success with the laser glaucoma procedure.

Patients undergoing cataract surgery should be examined carefully for glaucoma. Patients may have been diagnosed as glaucoma suspects in the past but never treated for glaucoma. At the time of cataract surgery, we can now treat most patients with glaucoma! These new class of surgeries are called Minimally Invasive Glaucoma Surgery or MIGS. If you have glaucoma or have been told you are a suspect for glaucoma, make sure your ophthalmologist evaluates you carefully for the possibility of a MIGS procedure. A routine cataract operation is very safe. Combining cataract surgery with a minimally invasive glaucoma surgery is a safe, quick, and effective approach for patients with cataracts and glaucoma.

The options for MIGS procedures are expanding constantly! Research and development in MIGS is very hot right now! Currently, the most common MIGS procedures are the i-Stent, Kahook Goniotomy, and Ab interno canaloplasty. At Metrolina Eye Associates, our surgeons offer all of these options for treating glaucoma and cataracts. In fact, our doctors were some of the first to perform these procedures in the area. Furthermore, our doctors have performed more of these procedures than most other doctors in the area! If your eye surgeon does not offer you an option for treating your glaucoma at the time of cataract surgery, give us a call! These MIGS procedures have now become the standard of care across the country.

By Dr. Dara Khalatbari