Treatment of glaucoma
Glaucoma - is a disease caused by increased intraocular pressure, causing damage to the cells of the retina and the optic nerve.
Diagnosis and treatment of glaucoma - is a complicated and responsible process. Symptoms are evident neither to the patient nor at routine inspection, so the diagnosis made on time based on high-precision methods of examination and competently chosen treatment are the key to a good prognosis. Treatment for glaucoma consists of maintaining an intraocular pressure parameters within normal limits (21 mm Hg), as well as the prevention of the consequences of elevated intraocular pressure effects on the structure of the eye.
Today our experts have access to all available techniques in the world, used for the treatment of glaucoma:
- Selection of adequate hypotensive therapy, providing normal intraocular pressure daily.
- Laser non-invasive interventions aimed at improving the outflow of intraocular fluid that reduces dependence on antiglaucomatous therapy: laser trabeculo-, gonio- and iridoplasty, iridotomy, and selective micropulse trabeculoplasty.
- Laser cyclophotocoagulation aimed at reducing pain symptoms at terminal stages of glaucoma.
- All kinds of antiglaucomatous surgery, including the implantation of drainage devices (valves, non-valvular) and donor amniotic membrane, stenting of Schlemm's canal.
Laser iridotomy is to form a perforation in the iris (coloboma), which will serve as an additional way for outflow of intraocular fluid and will lead to a reduction in intraocular pressure. It is performed at narrow and angle-closed form of glaucoma, imperforate pupil, as well as prophylactically to prevent an acute attack of angle-closure glaucoma. After surgery, an observation (control in 10-14 days, may be carried out at the place of residence) and the administration of an anti-inflammatory and antihypertensive therapy (tablets and drops within 10-14 days) are required.
Selective and micro pulse trabeculoplasty -are the most modern method of laser treatment for open-angle glaucoma that does not cause damage to the structures of the anterior chamber angle. The procedure is painless, is ambulatory and lasts only 3-5 minutes. In some cases, it eliminates the need to instillation of antiglaucoma drops. It is possible to repeat carrying out the procedure at decrease effect.
Laser transscleral cyclophotocoagulation is performed when the terminal stages of glaucoma with decompensation of intraocular pressure and severe pain in the absence of vision in this eye. The procedure is performed on an outpatient basis with the ineffectiveness of other methods of reducing the intraocular pressure. The procedure is contraindicated in patients with preserved visual functions, uveitis and severe eye malignancies. Cyclophotocoagulation can reduce intraocular pressure, as well as pain.
It should be mentioned that the treatment of glaucoma can be started only after a comprehensive eye examination, including: visometry (visual acuity), tonometry (measurement of intraocular pressure contact and non-contact method), check the fields of view (the kinetic and static computer perimetry), optical coherence imaging (allows to estimate the extent of damage to the optic disc), gonioscopy (examination of contact angle of the anterior chamber, which allows to determine the type of glaucoma, as well as factors affecting the increase in intraocular pressure) and other tests if required.
All diagnostics can be made at the hospital and takes no more than 2-3 hours.