The latest breakthrough in glaucoma treatment, Health News, ET HealthWorld
from dr Aditya Sethi
We’re sure you’ve heard of cardiac stents saving lives, but have you heard of a stent in the eye that saves vision?
Glaucoma is the leading cause of irreversible blindness in India. About 40 million people live with blindness. Even more unfortunate, 90 percent go undetected, resulting in permanent vision loss. Glaucoma issue is a crucial one in India as there are many obstacles in its detection and treatment such as: B. lack of knowledge about the disease, lack of availability of medical services, cost factor, higher illiteracy rate and so on and so forth.
Glaucoma is a preventable disease. Timely detection and treatment can save the patient from blindness during their lifetime. It is also known as the “silent thief of vision,” meaning that patients invariably have no symptoms until the final stage, when a significant degree of blindness has set in and cannot be reversed. dr Sahebaan Sethi says, “As a physician with years of experience treating glaucoma, I have seen firsthand the debilitating impact this disease can have on patients’ lives.” Glaucoma is a progressive eye disease that irreversibly damages the optic nerve and is left untreated can lead to vision loss. The condition is more common in people over the age of 40, in those with a family history of glaucoma, and in those with other medical conditions such as high blood pressure, diabetes, patients using steroids for allergies, asthma, autoimmune diseases, and those with eye trauma and patients who have a high number of glasses.
Treatment for glaucoma aims to preserve existing vision by lowering the pressure in the eye (pressure inside the eye). Different classes of anti-glaucoma drugs are available to control eye pressure, but they are not free from side effects. These include burning, itching, and redness of the eyes, as well as more serious side effects like difficulty breathing, slow heartbeat, fatigue, depression, impotence, etc. Additionally, these drugs can be expensive and place a financial burden on patients. Patients often have to use multiple eye drops daily to control intraocular pressure, which can be confusing and cumbersome, and results in very low compliance rates.
However, if drug therapy fails, surgery is required. There are three types of glaucoma surgery. Traditionally, the more aggressive open surgery called trabeculectomy or tube surgery with glaucoma drainage devices were used. Recently, our horizons have broadened with the introduction of MIGS (Minimally Invasive Glaucoma Surgery) in India. MIGS has found its niche in the American and European medical world for over a decade. Numerous randomized controlled studies and case series have well documented the clinical efficacy and safety of the MIGS procedure. MIGS procedures are typically performed using small incisions and specialized instruments that allow for a less invasive and safer surgical experience compared to traditional glaucoma surgeries. Some common MIGS procedures include trabecular bypass graft surgery, which creates a tiny opening in the eye’s drainage system to improve fluid drainage, and stenting surgery, which uses a small device to facilitate fluid drainage. MIGS procedures are typically performed on an outpatient basis, with a shorter recovery time compared to traditional surgeries. Each of these procedures has its own benefits and risks, and it’s important that patients discuss their options with their eye care professional to determine which treatment is right for them.
One of the most promising minimally invasive glaucoma surgeries (MIGS) is the iStent implant. This tiny device is designed to lower intraocular pressure (IOP) by creating a bypass in the eye’s drainage system, allowing fluid to flow out of the eye and regulating eye pressure. About the size of a grain of rice, the iStent implant is made of biocompatible titanium and is MRI compatible. It is the smallest US FDA-approved human implant. There are several advantages of MIG over traditional surgeries. One of the main advantages of the iStent implant is that it has very little to no risk of complications. Because the device is so small and the surgery is minimally invasive, patients typically experience very little discomfort and are able to return to their normal activities within a few days. Additionally, the iStent implant requires no special maintenance or aftercare, allowing patients to focus on enjoying their improved vision without the hassle of frequent doctor visits.
Another advantage of the iStent implant is that it is effective in treating a wide range of glaucoma patients. Unlike traditional glaucoma surgery, which is often reserved for patients with advanced disease or where other treatments have failed, the iStent implant can be used in patients with mild to moderate glaucoma. This means more patients can benefit from this innovative treatment, which has the potential to improve their quality of life and preserve their vision.
An ophthalmologist who is a pioneer in introducing MIGS in India is Dr. Sahebaan Sethi. She happens to be the first and only doctor to conduct a live demonstration surgery using this technology for nationwide ophthalmologists. She says, “The iStent implant is a game changer in the treatment of glaucoma. In my experience, patients who received the iStent implant have been very satisfied with their results. Many patients report improved vision and a reduction in symptoms such as eye inflammation, pain and fatigue. Because the iStent is implanted during cataract surgery, patients can enjoy the benefits of both procedures without the need for additional surgery or recovery time.”
“Until now, glaucoma surgery has been reserved for deathly blind patients due to the very high risk of complications, but with the launch of MIGS in India, we too can offer our patients a 100x safer option that makes early glaucoma treatment more accessible – moderate-stage glaucoma patients to her To better preserve vision before they go blind. MIGS also reduced dependency on eye drops, which greatly improves their quality of life. Of course, like any medical treatment, the iStent implant is not for everyone. Whether a patient is a good candidate for the procedure will be a joint decision between the patient and their specialist,” she concluded.
dr Aditya Sethi, Ophthalmologist, Arunodaya Deseret Eye Hospital
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