What is the best glaucoma treatment
Glaucoma OP - Medical Experts
Background information on glaucoma
Glaucoma, also known as glaucoma, is a series of diseases of the eye in which the Increased intraocular pressure. This gradually leads to damage to the optic nerve. In the worst case scenario, this can lead to blindness. Glaucoma surgery can prevent the condition from getting worse.
Open-angle and narrow-angle glaucoma
A general distinction is made between open-angle and narrow-angle glaucoma:
- The so-called Open-angle glaucoma is the far more common form. This is where the eyesight of the affected eye leavescreeping after.
- The Angle-closure glaucoma is much rarer. It is an acute form of glaucoma, which is associated with the very painful glaucoma attack andblindness within a very short time can lead.
Frequency and risk factors
Glaucoma is one of the most common causes of blindness worldwide, with the risk for the disease in generalincreases with age. Around four percent of all over 75 year olds are affected by the disease, and it is assumed that there are around one million glaucoma patients in Germany, although the number of unreported cases is very high.
There is also an increased risk of glaucoma if first-degree family members are already infected with glaucoma. Other risk factors include fluctuations in blood pressure, circulatory problems, diabetes and high myopia or farsightedness.
In general, everyone over the age of forty should see an ophthalmologist on a regular basisprevention to be examined. By measuring eye pressure and assessing the optic nerve, it can diagnose and treat glaucoma at an early stage.
Treatment of glaucoma
Treatment of glaucoma can initially be done with the help ofeye drop that are supposed to cause the intraocular pressure to drop. For this purpose, there are a large number of preparations with different mechanisms of action, some of which can also be combined with one another.
Glaucoma surgery may only be necessary if the medication does not have an adequate effect or is not tolerated by the patientPreserve eyesight. In most cases, this type of eye glaucoma operation is carried out on an outpatient basis and under local anesthesia.
Numerous procedures in glaucoma surgery
The procedure used for glaucoma surgery depends on the exact diagnosis and cause. The aim of all methods is to influence the intraocular pressure either through artificial drainage or through reduced production of aqueous humor.
Glaucoma surgery with the help of a laser is widespread and particularly patient-friendly.
Temporary remedy with laser trabeculoplasty
The glaucoma operation with the so-called selective laser trabeculoplasty leads to ahigher permeability the so-called trabecular meshwork in the eye. This is the tissue through which the aqueous humor drains. In this type of operation, a laser is aimed at the tissue of the trabecular meshwork. This creates small, holey scars in the spongy tissue, which improves the drainage of the aqueous humor. However, the effect of this glaucoma operation only lasts temporarily and is usually not permanent.
Iridectomy and iridotomy
The so-called iridectomy is a surgical procedure in which the doctor surgically cuts a small hole in the iris (rainbow skin). This creates a flow between the anterior and posterior chambers of the eye for the aqueous humor, through which the intraocular pressure can be regulated.
If this type of glaucoma operation is carried out on the eye with the help of a high-energy infrared laser, it is called an iridotomy. This procedure is standard today.
Iridotomy and iridectomy are the treatment of choice for narrow-angle glaucoma.
Trabeculectomy is a microsurgical procedure in which a kind ofValve for the drain of the aqueous humor is formed. In this glaucoma operation, a strip is cut out of the dermis as a drain. The aim of the procedure is also to lower the intraocular pressure by improving the drainage of the aqueous humor. This flows through the newly created drainage hole in the dermis under the conjunctiva and is taken up there by the body.
In contrast to trabeculectomy, in the so-called trabeculotomy, instead of a drainage channel, six to eight small holes are made for the drainage of the aqueous humor.
In cyclophotocoagulation, a laser beam obliterates the ciliary body (radiation body) that produces the eye fluid. The reduction in glandular tissue due to the sclerotherapy eventually leads to alower production of aqueous humor. The result of this operation is then the lowering of the intraocular pressure through less aqueous humor production.
After this procedure has been carried out, a scar forms in the ciliary body, which consequently produces less aqueous humor. The scarring takes about six to eight weeks. Therefore, the success of the operation can only be assessed about three months after the operation.
The operation can also be carried out using cold (cryocoagulation), but is only reserved for extremely severe cases.
Necessity and duration of glaucoma surgery
Glaucoma surgery is necessary when medication cannot reduce the pressure inside the eye sufficiently and permanentlyEndangerment of the optic nerve consists.
If the doctor uses a laser for the procedure, anesthesia is generally usedlocal anesthetic in the form of eye drops sufficient. General anesthesia may also be an option. This is the case, for example, with very anxious or nervous people who cannot keep their head still for a long time, or with interventions on both eyes and long-term operations.
How long the procedure takes depends largely on the technology or procedure used, as well as on the individual anatomical requirements of the patient. In general, a laser operation takes less time than the surgical variant.
Not all forms of glaucoma are equally suitable for an operation, here the doctor must weigh up whether they are suitable or the individual risk for the patient.
Risks and forecast
The risk generally depends on the technology used and the individual condition of the eye. Generally there are complications, such as
- a disorder of wound healing,
- Visual field defects or
- Postoperative bleeding
in the various forms of glaucoma surgeryvery rare. In this context, procedures in which the eyeball is opened are somewhat more risky than procedures using lasers. In some cases, if the surgery is unsuccessful, it can also happen that another surgical correction is necessary.
Complications can generally be effectively avoided or recognized at an early stage that theappropriate aftercare operates and takes it seriously. Close appointments for control are very important in order to recognize and treat possible complications at an early stage, as well as to be able to assess the success of the operation on the eye.
Surgery can also cause damage caused by glaucomacannot be reversed do. In such a case, a glaucoma operation ultimately serves to do that to preserve existing eyesight. Accordingly, a lack of vision improvement after glaucoma surgery should not be rated as a failure.
Before and after glaucoma surgery
Before a glaucoma operation, the doctor asks about medication that is taken regularly. Some preparations, such as blood-thinning substances, must be discontinued several days before a glaucoma operation to avoid complications.
If the eye operation is performed under general anesthesia, you are usually not allowed to eat or drink six hours before the anesthesia. It depends on the type of procedure and the anesthesia whether it is carried out on an outpatient or inpatient basis. In the case of an outpatient operation, the patient usually remains under observation for a few hours after the procedure.
For the period after the glaucoma operation, you are generally prescribed medication in the form of drops or ointments, the precise application of which is very important. In order to keep the stress for the patient as low as possible, the doctor often prescribes pain medication for the patient.
As part of theAftercare It is very important that you take the appropriate medication regularly, as prescribed, and that you keep your doctor's appointments. When at home
- Bleeding or
occur, you should contact the attending physician quickly and not wait long.
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