Issue 50.15
The Dixie Ophthalmic Specialists at Zion Eye Institute are introducing two new devices for the treatment of glaucoma: Visco 360 and Trab 360. “This new treatment is less invasive than previous procedures and takes only a few minutes,” said Marcos Reyes, MD, at Zion Eye Institute. I have been teaching cataract and glaucoma surgery for the last 6 years at a University in the midwest and this is one of the more exciting treatments for glaucoma that I have seen during that time, due to its less invasive nature and relatively quick operating time. A less invasive procedure makes for easier recovery for my patients.
The Visco 360 and Trab 360 devices are surgical instruments that open up the natural drainage system of the eye. More than 80% of glaucoma is due to blockage of the natural drainage system of the eye. This blockage leads to increased intraocular pressure which subsequently causes slow painless loss of vision. In fact, in many case people do not even know that they have glaucoma or peripheral loss of vision. It is estimated that 50% of people with glaucoma don’t yet know that they have the disease. It is only by checking the eye pressure, examining the optic nerve, and testing the peripheral vision that glaucoma changes can be detected. “I frequently tell my patients that most glaucoma is like high blood pressure in the sense that generally they can’t feel that their blood pressure or eye pressure is high.”
Glaucoma treatments are all aimed at lowering the eye pressure. Treatment often starts with laser or eye drops. Laser is done every few years and drops are given every day, sometimes multiple times a day. In many cases patients may need to use two, three, or four eye drops a day to control the pressure. As patients age, the drainage system of their eye ages. The eye pressure can slowly rise despite being on drops or having had laser in the past. This is just part of the normal process of glaucoma. It is exciting to now have a device that can open the aging drainage system.
Visco 360 and Trab 360 are performed using a small opening in the cornea and a special prism to directly visualize the trabecular meshwork (the name for the opening of the drainage system) which covers the drainage canal. While directly visualizing the meshwork either the Visco 360 or Trab 360 is inserted through the meshwork, into the drainage canal and a catheter is carefully dialed into the canal. While within the drainage system two things can be done. Using the Visco 360 device we can use a jelly like substance to stretch and widen the drainage canal. If the pressure is very high we can use the Trab 360 device to completely unzip the meshwork allowing the fluid in the eye to have direct access to the drainage canal. Other times we will do a combination of the two procedures. This all depends on the extent of the glaucoma damage. Several studies have shown that after treatment, most patients achieved lower eye pressure and reduced their need to take eye drops. This translates into more vision saved for our patients.
Trab 360 or Visco 360 can be performed alone or combined with cataract surgery in patients who need cataract surgery and also have glaucoma.
This is one more minimally invasive treatment we can employ prior to more invasive surgical treatment.
For more information, or to schedule an appointment, contact Dixie Ophthalmic Specialists, 1791 E. 280 N., St. George, or call 435-656-2020.