Glaucoma

Glaucoma is a leading cause of blindness in the United States , especially for older people. But loss of sight from glaucoma is preventable if you get treatment early enough. Glaucoma is a disease of the optic nerve. The optic nerve carries the images we see to the brain. Many people know that glaucoma has something to do with pressure inside the eye. The higher the pressure inside the eye, the greater the chance of damage to the optic nerve.
The optic nerve is like an electric cable containing a huge number of wires. Glaucoma can damage nerve fibers, causing blind spots to develop.

Often people don’t notice these blind areas until much optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and blindness from glaucoma.

Aquaflow
The AquaFlow is a tiny piece of collagen that is implanted in a space carefully prepared by your doctor under the white of the eye. It maintains the space created by your doctor to increase fluid outflow in order to reduce pressure within the eye. The AquaFlow Collagen Glaucoma Drainage Device when used with a non-penetrating deep sclerectomy procedure has been proven to significantly lower intraocular pressure while minimizing both the complications often associated with penetrating procedures and reducing the need for medications.

The Procedure

The procedure to implant the AquaFlow device requires approximately 30 – 45 minutes from start to finish. In most cases, the patient is made comfortable with a mild sedative while anesthetics are used to numb the eye.

Occasionally, patients require additional sedation. Postoperatively, medications (anti-inflammatories and antibiotic eyedrops) are prescribed. A protective shield may also be worn for a short period of time. Your doctor will probably caution you not to rub your eye following surgery.

A follow-up appointment is usually made for the day after surgery. Patients are most often able to return to their normal activities within 24 hours. Additional visits will be scheduled as recommended by your doctor.

Within 6 to 9 months, the AquaFlow is slowly resorbed; leaving a porous matrix of tissue in the space created by the doctor, allowing fluid to continue to drain from the eye to keep intraocular pressure low.

Trabeculectomy
Trabeculectomy is a glaucoma surgery that creates an alternative drainage pathway for fluid in the eye, thereby lowering the eye pressure.
The Procdure

Surgery is done in an outpatient operating room with a local anesthetic injection. The conjunctiva, the mucous membrane overlying the white part of the eye, is incised and dissected off the eye. A small trapdoor flap is then created in the sclera, the thicker white part of the eye underlying the conjunctiva. Beneath this flap a tiny hole is created to allow fluid to flow out of the eye. The trapdoor flap is then gently stitched down so that the fluid coming out of the eye is controlled. The conjunctiva is subsequently stitched back in place in a watertight fashion so the fluid from the eye collects beneath it, forming a small elevation called a bleb.

Post-surgery

After surgery, frequent eye drops are needed to promote controlled healing. Careful postoperative monitoring is needed to prevent infection, scarring, or leaking from the incision. Often, the stitches holding the trapdoor flap in place will be selectively cut using a laser to permit adequate fluid flow beneath the flap.

Plasma Blade
Fugo Blade/Plasma Blade
Highly precise instruments like the Fugo Blade are especially useful in cataract surgery and in surgical treatment of glaucoma. Having laser-like interaction with tissue, the Fugo blade cuts with a 100-micron filament that heats to 450°C. The heat is extremely focused so there is minimal damage to surrounding tissue.

The Procedure

Transciliary Filtration for Glaucoma . The Fugo Blade creates a small pore through the sclera and ciliary body without true cutting, using plasma energy surrounding its filament. The tissue bonds separate, allowing a nearly resistance-free incision and minimal bleeding. The incision acts like a bypass to help the eye’s natural fluid drain more easily and thereby lower eye pressure.

Capsulotomy for Cataract Surgery

The Fugo Blade provides superior control for opening poorly visible and excessively elastic lens capsules, thereby increasing the safety of cataract surgery. Some researchers have found that this form of lens capsule opening may improve edge strength. The added stability and durability can be especially useful for pediatric cataracts.

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