Glaucoma: the best treatments available today

Written by: Mr Vik Sharma
Published:
Edited by: Top Doctors®

In the second of two articles on glaucoma, top London-based ophthalmologist Vik Sharma takes us through the treatment options available for the disease.

Glaucoma drainage surgery

 

Using powerful anti-scarring agents and releasable stitches, glaucoma drainage surgery is a proven method to give you optimal results. The procedure can be performed under local anaesthetic so you are able to go home on the same day.

Xen® implant


A Xen® implant is a 6mm microtube, inserted with no cuts or stitches in the conjunctiva and performed with just drops in under 5 minutes. This microtube is so small and effective it has revolutionised glaucoma surgery allowing us to simplify the procedure and still have the benefits of safe, long lasting drainage.

 

Trabeculectomy

 

This operation entails forming a small channel through the white part of the eye. This channel will allow fluid - made naturally in the eye - to drain away. Some patients will require a special medication (Mitomycin C) to be placed around the incision site to try to ensure that the hole does not scar over. The drainage site is under the upper eyelid and will not be seen, and once settled should not cause you discomfort. The fluid will drain from the channel and be absorbed by conjunctival vessels in the skin of the eye.

Canaloplasty


This is a new procedure which uses safer, non-penetrating techniques to open up the drainage canal without ever entering the eye. These new techniques allow safe and effective surgical treatment for high eye pressures.

iStent®

 

The iStent® is a new drainage device which safely lowers pressure the natural way without having to cut into the skin (conjunctiva), so reducing the risk of scarring or failure. It is a quick and effective way of lowering pressure, with less trauma to the eye than conventional surgery.

Laser and eye drop treatments:

 

Glaucoma laser treatment has become increasingly common and can in many cases mean the patient can resume normal activities in a short amount of time. There are various types of laser surgery options most of which will still be combined with medication of some kind. This combined approach should help to reduce intraocular eye pressure and maintain it too. Having any surgery can be daunting but glaucoma laser surgery is usually a faster and more effective treatment with little interference to daily life once complete. Sometimes it might be necessary to repeat a procedure but individual outcomes and next steps can be discussed with an ophthalmologist.

Micropulse diode and selective Laser


This is a new and repeatable treatment without scarring, that painlessly lowers pressure and allows many patients to do away with their daily eye drops. Micropulse technology utilises the most advanced laser energy, to deliver highly accurate and precise treatment, without unwanted side effects. This allows a consultant ophthalmologist to deliver new treatments which were not possible, or as effective, with previous argon type lasers.

By Mr Vik Sharma
Ophthalmology

Mr Vik Sharma is extensively trained, and has gained expertise, in lens surgery, glaucoma, eyelid surgery, and retinal treatments, as well as general ophthalmology.

Mr Sharma is a glaucoma specialist who offers new non-penetrating surgical techniques and micro-tube implants, the latest micro-pulse laser treatment, and micro-incision cataract surgery with monofocal and multifocal lens implants.

He is an experienced glaucoma and cataract surgeon, using topical anaesthesia and on-axis phacoemulsification as part of his technique. At LondonOC, he is a consultant ophthalmic surgeon and also clinical director, and has introduced the use of micro-incision phacoemulsification with sub-2mm incision for cataract surgery. This technique reduces trauma to the eye, which leads to faster healing and decreased post-treatment complications.

Since 2007, he has been a holder of a substantive NHS consultant post with the Royal Free Hampstead NHS Trust, Edgware, and Barnet Hospitals, London, where he is the clinical lead in glaucoma.

Mr Sharma is developing a new modern service for patients in North London.

Mr Sharma is a Fellow of the Royal College of Ophthalmologists and a fully accredited consultant on the UK General Medical Council Specialist Register. As well as completing a glaucoma fellowship in London, he has also undergone further training in oculoplastics.

He has authored many ophthalmology chapters in medical texts and in peer-reviewed journals and remains an active member of the medical research field, presenting internationally and locally, discussing research findings and new techniques/treatments.

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