Per McGowan Institute for Regenerative Medicine
faculty member Joel Schuman, MD (pictured), director of the UPMC Eye Center and chairman of the Department of Ophthalmology at the University of Pittsburgh School of Medicine, “Glaucoma can be treated, and sight can be preserved – if the disease is detected early and treatment follows.” Glaucoma is the leading cause of blindness worldwide and usually has no symptoms until it’s too late – leaving about half of people with the disease unaware of having it until they experience vision loss. Dr. Schuman recommends regular screenings for glaucoma to detect the disease early. Since damage caused by glaucoma cannot be reversed, these screenings are vital – especially for those at high risk of developing the disease. If treatment is necessary, there are two new surgery options now available in Pittsburgh: Canaloplasty and ab interno trabeculectomy (AIT). Unlike earlier treatment options, these are minimally invasive.
A clear fluid, called aqueous humor, fills the front of your eye and provides nourishment to the tissues. Like the air in a balloon, the aqueous humor also provides pressure to help maintain the shape of the eye. In most types of glaucoma, the eye’s natural drainage system loses function and the fluid inside the eye cannot drain. This lack of drainage causes an elevation of pressure within the eye. This increase in intraocular pressure (IOP) exerts pressure on the optic nerve and results in vision loss. To prevent this from happening, it is essential to lower your IOP.
The first sign of glaucoma is often the loss of peripheral or side vision.
Canaloplasty is proven to safely lower IOP and dependence on medications. And unlike traditional procedures, canaloplasty is minimally invasive and has fewer complications and less follow-up. Canaloplasty uses breakthrough microcatheter technology in a simple and minimally invasive procedure. To perform canaloplasty, a tiny incision to gain access to a canal in the eye is created. A microcatheter circumnavigates the canal around your iris, enlarging the main drainage channel and its smaller collector channels through the injection of a sterile, gel-like material called viscoelastic. The catheter is then removed and a suture is placed within the canal and tightened. This tightened suture ensures that the canal remains open. By opening the canal, the pressure inside the eye is relieved.
AIT is the removal of diseased tissue using an electrosurgical pulse. Continuous irrigation and aspiration removes debris and regulates temperatures. The NeoMedix technology, Trabectome, works to help the body help itself. Designed to improve fluid drainage from the eye and balance intraocular pressure, this minimally invasive procedure stabilizes the optic nerve to minimize further visual field damage. Trabectome safely ablates and removes a 60°-120° strip of trabecular meshwork using a focused electrosurgical pulse and re-establishes access to the eye’s natural drainage pathway.
Since there is no cure for glaucoma, Dr. Schuman says, “With glaucoma surgery, the purpose is to protect your vision, and to preserve the vision you have remaining.”
“Being examined by an ophthalmologist at least every 2 years after turning 40 is key to preventing blindness,” said Dr. Schuman.
Illustration: McGowan Institute for Regenerative Medicine.
Pittsburgh Post-Gazette (02/25/09)
UPMC Media Relations (03/12/09)
Bio: Dr. Joel Schuman