Minimally invasive glaucoma surgery seen as big success

PHOTO: Denise Ritchie  — New Vision Eye Center’s Dr. Stephen Tate is excited about the success of minimally invasive glaucoma surgery – aptly dubbed “MIGS” – and a new type of ocular stent intended to “provide glaucoma patients surgical interventions much earlier in the disease that are safer than traditional glaucoma surgeries.”

Better glaucoma surgery is a big deal because more than 3 million Americans have the disease and, according to the Mayo Clinic, it “is one of the leading causes of blindness for people over the age of 60.”

Glaucoma is caused by pressure on the optic nerve – which transmits images from your eye to your brain – that results when fluids that build up inside the eye are unable to drain properly.

The Glaucoma Research Foundation reports that “standard glaucoma surgeries are major surgeries. While they are very often effective at lowering eye pressure and preventing progression of glaucoma, they have a long list of potential complications.”

Now, MIGS and a newly FDA-approved stent are offering a safer way to treat this sight-stealing disease in patients who are diagnosed early.

When the disease is detected early, Tate says, MIGS surgeries “have been shown to be very, very safe with very, very low risk of adding any untoward event to the surgery and they can very safely get people a pressure reduction” on their optic nerve.

He adds that “people who have very severe glaucoma and are getting visual field loss or vision loss and are maxed out on medications” still have to rely on the old, tried-and-true glaucoma surgery to save their vision, because, by that time, there are “no other alternatives.”

The key to the success of the newer technique is the new stent that helps drain the fluid that can damage the optic nerve. Produced by Ivantis, the “hydrus” micro-stent was approved by the FDA in August of 2018.

It is now available at New Vision where doctors say it is much more effective in relieving pressure on the optic nerve by draining more fluid from the eye than earlier stents.

“The hydrus stent was part of one of the largest FDA studies for a glaucoma device that’s ever been done,” Tate says. The study, which followed 4,000 patients, found that “close to 80 percent of patients were able to stop one of their eyedrop medications afterward and the pressure-lowering effect of the device continued over several years.

“The patients who had this implanted, their pressure actually tended to trend down over the duration [of the study] … which is really nice.”

As an added bonus, the MIGS procedure and micro-stent implantation can be easily incorporated into cataract removal surgery.

Why bring cataracts into the conversation?

That’s simple. As Tate points out, “just about everybody will have cataracts if they live long enough. That’s a fact of life,” and almost all studies have shown “no significant difference in risks by adding this [MIGS] to cataract surgery. The patients are not at any additional risk by doing this and they have been shown to decrease the odds that their glaucoma continues to progress. And if it does progress, that progress is slower than in somebody who has not had one of these interventions.”

“We’ve been very happy” with both the MIGS procedures and the new stents, says Tate.

He adds that New Vision’s own internal data mimics the FDA studies. “A little over 80 percent” of New Vision patients who’ve had these new procedures and stents “have now been taken off one their medications.”

Dr. Stephen Tate is with New Vision Eye Center at 1055 37th Place in Vero Beach. The phone number is 772-257-8700.

Leave a Comment