Glaucoma is a set of diseases in which fluid and pressure damage the eye’s optic nerve, the part of the eye responsible for sending information collected by the retina to the brain. When fluid produced by the eye fails to drain normally, it creates pressure inside the optic nerve, resulting in vision loss. The most common form of glaucoma is primary open-angle glaucoma, or POAG, accounting for roughly 95% of glaucoma cases and affecting 2.7 million Americans ages 40 and older.
A cataract is a clouding of crystalen proteins within the lens of the eye, distorting and clouding vision. Also common as people age, cataracts can increase intraocular pressure, exacerbating POAG.
“Left untreated, both glaucoma and cataracts can lead to blindness,” says ophthalmologist Scot Holman, MD. “Having both conditions together places vision at serious risk.”
Luckily, years of research and technology have produced new approaches to treating both glaucoma and cataracts during the same surgical appointment. The latest is the Hydrus® Microstent, an advanced therapy created specifically for patients with POAG. Inserted into a key drainage vessel called Schlemm’s canal immediately following cataract surgery, the Hydrus Microstent has been shown to promote normal fluid outflow, reducing eye pressure. After receiving the Hydrus Microstent, most patients are able to reduce or eliminate their dependence on glaucoma medication. “The Hydrus Microstent is extremely tiny, about the size of an eyelash,” says Dr. Holman. “It is implanted via microscopic incisions, which heal quickly and pose less chance of complication than conventional glaucoma surgical methods.”
“The Hydrus Microstent opens and expands the eye’s natural drainage channel, so the eye expresses fluid more like a normal healthy eye,” says Dr. Holman. The Hydrus Microstent is so effective that more than 3 out of 4 glaucoma patients experience a significant reduction in eye pressure compared to cataract surgery alone, and are able to remain drop-free two years following surgery.
Adult cataract patients with mild to moderate POAG and otherwise normal eye anatomy may qualify for the Hydrus Microstent. Eligible patients can have the microstent inserted immediately after cataract removal using the same corneal incision, making this outpatient procedure remarkably quick and safe, with minimal healing time.
Other options for adults with mild to moderate POAG planning to have cataract surgery include iStent® and iStent inject® Trabecular Micro-Bypass implants, the world’s smallest FDA-approved medical implants. 20,000 times smaller than an intraocular lens, the iStent and iStent inject reduce excess fluid and lower eye pressure so successfully that many patients find they can limit or stop using glaucoma medication for a year after receiving the implant. “After getting the iStent inject, most patients are able to maintain healthy eye pressure and reduce or eliminate their need of eye drops,” says ophthalmologist Scott Wehrly, MD. “The procedure comes with about the same minimal risk and recovery times as cataract surgery alone, making it a revolutionary way to help stop glaucoma’s damage in its tracks.”
“The iStent opens up the eye’s drainage system so that fluid can flow more freely,” says ophthalmologist Vinay Gutti, MD. “The iStent inject is even more powerful, with two tiny stents for greater control of excess fluid and pressure. Both systems work to help prevent further POAG-related vision loss.”
The Hydrus Microstent, iStent and iStent inject are not suitable for patients with primary- or secondary-angle-closure glaucoma and certain other diseases.
If you have POAG and are considering cataract surgery, talk to your Lake Eye doctor about whether these revolutionary glaucoma treatments may be used to help manage or even stop the progression of glaucoma and reduce your need of glaucoma medications. You could see better vision, comfort and protection in your future.