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Glaucoma Information

Glaucoma is one of the leading causes of permanent blindness in the world. It affects two to three million Americans, and more than twelve million people worldwide. Glaucoma takes away a victim's sight slowly, but relentlessly, and in most cases, without any signs or symptoms. Visual damage from glaucoma is irreversible and permanent. Blindness from glaucoma, however, can be prevented with proper preventive eye care.

Who is at Risk?
Glaucoma can strike people of any age, sex, and race. Certain individuals, however, are at increased risk. Those at increased risk include persons of African descent, those with a family history of glaucoma, persons with diabetes and possibly those with nearsightedness or high blood pressure. The risk of glaucoma also increases as one gets older. The risk of glaucoma increases markedly in people of African descent over the age of 35 years, and in people of Caucasian descent over the age of 50 years. Other risk factors for glaucoma include a history of trauma to the eye.

What is Glaucoma?
Glaucoma is a disease that affects the optic nerve, which is the nerve that connects your eye to your brain. This nerve transmits visual information from the eye to the brain, thereby allowing you to see. In most cases, glaucoma damage progresses very slowly, over a period of several years. However, sometimes this damage can progress more rapidly. As the damage to the nerve progresses, a person begins to lose vision. This loss of vision begins with the side, or peripheral, vision. This is vision that you may not be aware of, but is very important in everyday activities of mobility such as walking and driving.

The loss of this peripheral vision progresses as long as the disease is not treated. If treatment is not given or not effective, then the visual loss can progress until it begins to involve the central, or vision used to read and write. It is at this point that a victim of glaucoma may begin to notice problems with vision. If treatment is still not given, then all vision in the eye can be lost. Visual loss from glaucoma is irreversible. Because vision lost from glaucoma can never be restored, it is critical to detect glaucoma before significant damage has occurred to the nerve and initiate effective treatment. Even if vision loss has occurred, treatment for glaucoma can be provided to prevent further loss of vision.

How is glaucoma diagnosed?
Because there are usually no noticeable symptoms of glaucoma, it is important to have your eyes checked by a doctor. A simple test at the doctor's office can determine if you have glaucoma. Regular eye examinations are important because studies suggest that early diagnosis and treatment of glaucoma can slow the progression of the disease.

How is glaucoma treated?
Traditional glaucoma treatment is medication that is usually in the form of eyedrops. An individual with glaucoma would require one or more drops of medication every day throughout his or her lifetime. These medications decrease eye pressure, either by slowing the production of the fluid in the eye or by increasing the outflow from the eye.

There is no cure for glaucoma. Therefore, patients usually require lifelong medical treatment to control their pressure. For some patients, difficulty using eyedrops or the side effects (ranging from those that affect the eyes such as stinging, burning, tearing and blurred vision, to those that affect the whole body; including anxiety, dizziness, tremor and others) may cause interruptions in therapy.

Sometimes, glaucoma may not respond to medication. In these cases laser or surgical options may be required. The AquaFlow™ and a non-penetrating deep sclerectomy procedure are one of the newest forms of surgery used for the treatment of glaucoma.

As with any medical condition, treatment options should be discussed with your doctor.

The AquaFlow™ Collagen Glaucoma Drainage Device


The AquaFlow is a tiny piece of collagen that is implanted in a space carefully prepared by your doctor under the white of the eye. It maintains the space created by your doctor to increase fluid outflow in order to reduce pressure within the eye. The AquaFlow Collagen Glaucoma Drainage Device when used with a non-penetrating deep sclerectomy procedure has been proven to significantly lower intraocular pressure while minimizing both the complications often associated with penetrating procedures and reducing the need for medications.

The procedure to implant the AquaFlow device requires approximately 30 - 45 minutes from start to finish. In most cases, the patient is made comfortable with a mild sedative while anesthetics are used to numb the eye.

Occasionally, patients require additional sedation. Postoperatively, medications (anti-inflammatories and antibiotic eyedrops) are prescribed. A protective shield may also be worn for a short period of time. Your doctor will probably caution you not to rub your eye following surgery.

A follow-up appointment is usually made for the day after surgery. Patients are most often able to return to their normal activities within 24 hours. Additional visits will be scheduled as recommended by your doctor.

Within 6 to 9 months, the AquaFlow is slowly resorbed; leaving a porous matrix of tissue in the space created by the doctor, allowing fluid to continue to drain from the eye to keep intraocular pressure low.

Ask your doctor to discuss your treatment options with you.

FAQs

Q. If I have the AquaFlow glaucoma surgery, how likely will it be that I will be able to stop using my glaucoma eye drops?
A. Clinical studies that were conducted to prove the effectiveness and safety of the AquaFlow procedure indicated that patients were using 2.3 different medications prior to surgery and .3 after the surgery. This data indicates that most patients can eliminate the use of eye pressure lowering drops following the procedure.

Q. Is the AquaFlow surgery or recovery after the surgery painful?
A. Medications are used to numb the eye during the surgery so there is no pain or uncomfortable feelings. Most patients report little discomfort after the surgery other than the sensation of itching from normal healing or occasional scratchiness from the stitches.

Q. Is the AquaFlow surgery performed in the doctor's office or a hospital?
A. This glaucoma surgery must be performed in a surgical suite. This requires the location be a hospital outpatient surgery area or an ambulatory surgical center.

Q. Will I be asleep during the AquaFlow surgery?
A. Your surgeon may choose general anesthesia, however others prefer to numb the eye with the patient relaxed with a medication but not asleep.

Q. What if the AquaFlow surgery does not reduce my eye pressure to levels that stops the glaucoma progression?
A. If your eye doctor believes that lower pressures are needed after observing the effect of the surgery, they will recommmend a laser treatment that enhances the original AquaFlow procedure. Typical added eye pressure reductions with the laser are 40-50% greater than that achieved with the original surgery. The alternative is to return to a reduced amount of the eye drops used to lower the eye pressure prior to surgery.

Q. Will I need to use any eye drops after my glaucoma surgery?
A. All eye surgery cases will require the use of drops to prevent infection and reduce inflammation. These drops are used for the first few weeks and in some cases a month or two and then discontinued.

Q. How much does the AquaFlow glaucoma surgery cost?
A. The fee charged for the AquaFlow procedure is established by the surgeon and can vary. Medicare and other managed care/insurance plans provide reimbursement for this procedure.

Q. What happens to the AquaFlow collagen device that is placed in my eye?
A. The AquaFlow collagen device gradually dissolves over a period of six to nine months once placed in the eye.

Q. What complications could occur with the AquaFlow surgery?
A. Any type of surgery has risks of complications with the most common being infection and inflammation. Eye drops are used to prevent these complications or keep to a minimum. Studies have shown low percentages of complication rates with AquaFlow compared to other types of glaucoma surgery

Q. Will my eye look different after the AquaFlow surgery?
A. Patient's eye appearance after AquaFlow surgery is usually very normal and natural. During the first week there may be some redness to the eye but this clears quickly as the eye heals.

Q. Are there any restrictions in my activities after the AquaFlow surgery?
A. It is wise to be cautious and minimize strenuous activities for a few days following your eye surgery. Normal activities can usually resume after 5 to 7 following the procedure.
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