Aging eyes benefiting from new surgical methods to treat cataracts and glaucoma
BY LIDIA DINKOVA
Like many older people, Nestor Pous, 73, was diagnosed with cataracts as well as with glaucoma, both eye conditions that arise with age.
But unlike many others, Pous had both conditions repaired through surgery.
New technology in use for about three years allows doctors to treat glaucoma as well as cataracts during one surgical procedure.
“It’s going to allow a big percentage of patients who are undergoing cataract surgery to kill two birds with one stone and attack the glaucoma,” said Dr. Carlos Buznego, ophthalmic surgeon with the Center for Excellence in Eye Care at Baptist Hospital Medical Arts Building.
Prior to this treatment, doctors would do surgery to treat cataracts but they usually wouldn’t do surgery to treat glaucoma unless it was a severe case. Long healing times and complications were common in glaucoma surgery. In general, doctors treated glaucoma with prescription eye drops that a patient would have to use for a lifetime.
The Food and Drug Administration approved the iStent device, in 2012 following a trial the FDA conducted on 240 eyes with cataracts and mild- to moderate glaucoma across 27 sites in the United States, including Baptist Medical Arts Surgery Center.
Buznego, who implanted the iStent in Baptist patients as part of the trial, said the trial showed the stent didn’t compromise the cataract procedure and that it allowed patients to stop glaucoma medication. Indeed, 68 percent of the patients who were part of the year-long trial are medication free, according to the iStent manufacturer, Glaukos.
The iStent targets glaucoma by unblocking the trabecular meshwork and allowing clear fluidthat nourishes parts of the front of the eye to flow through the meshwork. In open-angle glaucoma, which is the type the iStent treats, the trabecular meshwork is blocked and the clear fluid can’t flow through. As a result, pressure on the optic nerve, or the nerve that transmits images from the retina to the brain, builds up.
“The problem with traditional glaucoma surgery was we are diverting fluid to an area where it probably not ought to go,” Buznego said.
The trabecular meshwork, however, is the natural and correct path for the aqueous humor fluid to flow through.