New technology offers quicker recovery, better results after vision-saving glaucoma surgery

Dr. Karanjit Kooner

When conventional therapies for glaucoma have been exhausted, ophthalmologists at UT Southwestern Medical Center at Dallas have a new surgical technique in their arsenal to arrest this blinding disease caused when there is too much pressure on the inside of the eye.

UT Southwestern ophthalmologists are among a few in the Dallas area to use the recently approved Ex-PRESS Mini Glaucoma Shunt, a metal cylinder smaller than a grain of rice. It is surgically implanted in the eye and offers an escape route for the pressure-causing fluid.

“There are several advantages associated with this shunt,” said Dr. Karanjit Kooner, associate professor of ophthalmology. “The small size requires minimal manipulation of tissues; the procedure is rapid and reversible; and postoperative inflammation is minimal. I have had great success with this procedure. The average reduction of intraocular pressure was about 40 percent, and many patients were able to stop using their glaucoma medications.”

Dr. Kooner reported on the technique he uses to implant the shunt at the annual American Ocular Surgery Symposium in New York in mid-September.

The shunt received Food and Drug Administration approval in March 2002. So far about 700 ophthalmologists nationwide have trained to do the procedure, including about 50 in Texas.

Conventional shunts used to treat glaucoma are larger, forcing ophthalmologists to make bigger cuts on the eye. Now, the incision is between 2 millimeters and 4 mm long – about half the size necessary to accommodate other shunts.

As a result, the surgery is less invasive and causes less scar tissue, making the procedure more likely to succeed. Previously, large amounts of scar tissue sometimes formed, blocking the relief channel.

Patients also experience shorter healing times with the new shunt. The surgery doesn’t require a hospital stay and takes less than an hour. A patch is worn over the eye for about a day and vision is blurry for about a week after the procedure. Typically, patients are able to return to work after a week of recuperation.

More than 5 million Americans are at risk for developing glaucoma, the third leading cause of blindness worldwide. In the majority of patients, the cause is unknown, but heredity, trauma and certain drugs may play a role. The risk factors for glaucoma include being older than 40, of African-American descent, a family history of the disease, or having systemic hypertension or diabetes.

To find out more about the surgery, please call 214-648-2020.

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