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Glaucoma Surgery Department
surgical and medical glaucoma treatment
At IRTC “Eye Microsurgery” Glaucoma department for today more than 50 000 operations were performed in patients with various types of glaucoma.
Our vast experience allows providing effective aid for the patient at any stage of disease.
At the moment there are three main trends in glaucoma treatment: medical, laser and surgical.
Glaucoma cannot be cured by medical means, by use of medications: it is the struggle with symptoms, instead of the disease.
Therefore ITRC “Eye Microsurgery” specialists developed and successfully use new quality methods of glaucoma treatment which are effective, safe, and mild, such as laser operation and surgical intervention.
In the first case laser beam penetrating into the eye with no hindrance affects the draining system and improves outflow of intraocular liquid. Laser treatment is painless, takes short time, and it is performed in outpatients. Its essential advantage is that the eyeball doesn’t undergo surgical impact.
Unfortunately, laser beam helps not each and every patient suffering from glaucoma. This kind of treatment can be effective only on initial stages of the disease when intraocular pressure is increased and in above-mentioned glaucoma attacks.
Surgical intervention is the most effective treatment method for the handsome majority of patients suffering from this ailment.
Academician S.N.Fyodorov considered that glaucoma should be diagnosed and treated surgically much earlier than it is practiced now. It is proved that the use of traditional medications often doesn’t help but on the contrary negatively influences the eye. Whereas the earliest possible surgical intervention creating the new way for the intraocular liquid outflow will provide vision preservation in patients suffering from glaucoma.
This operation being new in principle, created at IRTC “Eye Microsurgery” has got the name of “non-penetrating deep sclerectomy” (NPDS). It can be successfully used in any form of open-angle glaucoma. The most important advantage of the new operation is that it is performed without opening the eyeball.
Thus the possibility of infection’s access is excluded and complication risk during operation is diminished. Non-penetrating deep sclerectomy is performed under local anesthesia with obligatory participation of anesthesiologists who will prepare you to surgical intervention and will help to release your stress.
Operation is performed with use of the most up-to-date surgical microscope. Special microsurgical instruments with edges made of diamond, sapphire, and other highly solid material are used to perform this operation. Average duration of the operation makes up 20 minutes.
Last achievement of IRTC “Eye Microsurgery” scientists is use of excimer laser instead of edges to perform non-penetrating deep sclerectomy, so that the operation is performed on the molecular level.
NPDS technology’s perfection allows significantly shortening the post-operative treatment period (to few days). In some cases the operation can be performed even in outpatient.
Support of the maximal duration of antiglaucomatous operation hypotensive effect is an important condition for successful surgical treatment of glaucoma.
Performed surgical intervention against glaucoma is aimed at increased intraocular pressure lowering. But often with time after the operation intraocular pressure increases again. This can demand prescribing anti-glaucomatous drops or even to repeat the operation.
The reason of repeated rise of the pressure is due to the scarring in the area of the newly formed ducts for the eye liquid outflow.
Overgrowing of any “aperture” or thinning in the eyeball wall is a normal reaction of the tissue to the surgical injury. It cannot be completely prevented, and is not necessary because it can cause complications.
At IRTC “Eye Microsurgery” specialists have learnt to control healing processes in the eye.
The first method to prevent scarring of the operation’s zone is diminishing of the tissue injury. For this aim we use the sharpest surgical instruments - diamond edges allowing to dissect or even to divide (instead of squeezing or rupturing) tissues on the level of large molecules. At the same time we perform removal of sclera layers by means of the most up-to-date excimer laser.
Laser beam gives an opportunity to perform dosed ablution (evaporation) of the sclera. Every impulse removes 2 mikrons of tissue.
Accidental damage of the surrounding tissues is merely excluded and simultaneously with ablution hemostasis (arrest of bleeding from small capillaries due to the vessels coagulation) occurs.
Cells and collagen fibers of the sclera residing after the operation merely do not “feel” that their neighbors were removed therefore they manifest their ability to compensate the lost tissue to the minimal extent.
The second method to prevent scarring is to use cytostatic medications allowing to control healing processes that increases the period of the surgical effect.
The Department is engaged in treatment of the particularly severe forms of glaucoma such as neovascular, post-traumatic, post-uveal, multiply operated and others. Operations and drainage developed by the staff allow gaining positive effect in significant number of such severe patients.
Methods of preservation and increase of visual functions in glaucoma
It should be mentioned here that normalization of ophthalmic tonus does not always provide visual functions stabilization. One of the main reasons of vision decrease in glaucoma is disturbance of blood supply (hemodynamics) of the eye. For this state correction at IRTC “Eye Microsurgery” Glaucoma department different kinds of vasoreconstructive operations increasing blood flow in the eye artery are performed.
To stabilize and increase visual functions, especially in far-advanced glaucoma magnetic and laser stimulation of the optic nerve can be successfully used.
For the combination of glaucoma and cataract in one patient surgical treatment method was developed that means antiglaucomatous operation (NPDS) and cataract extraction with intraocular lens implantation being simultaneously performed. (For more information click “Experimental Surgery Center”). For cataract removal most up-to-date methods such as phacoemulsification, phacolaser technologies are used. Lens implantation (artificial crystalline lens) is performed even in patients with far advanced glaucoma stage.
Thus, today our specialists possess a vast range of means affecting various links of glaucoma pathogenesis able to provide the patient with full volume aid. Extensive experience of glaucoma “non-penetrating” microsurgery use was accumulated – over 45.000 patients with various stages of disease. It was admitted that this is the most perspective trend in glaucoma surgical treatment.
We would like to attract your attention to the fact that particularly all-round and individual approach to choose glaucoma treatment method that you are suggested at IRTC “Eye Microsurgery” allows preserving vision for many thousands of patients suffering from this disease.
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