Glaucoma is a disease that affects the optic nerve, which transmits images from the eye to the brain. It affects more than 3 million people in the United States and is typically associated with high pressure inside the eye (intraocular pressure). Most patients with glaucoma have few or no early symptoms. But if the condition is not treated effectively by lowering intraocular pressure with medication, laser therapy, or surgery, patients can suffer permanent vision loss.
Traditional glaucoma surgery itself carries the potential risk of temporary or, less often, permanent vision loss, and usually requires a long recovery period with multiple follow-up appointments. Today, however, we can offer patients two new glaucoma medications for lowering intraocular pressure, an office-based laser treatment, as well as minimally invasive glaucoma surgeries (MIGS) that are relatively safe and effective with the potential for quicker visual recovery.
The latest glaucoma treatments
Glaucoma treatment usually begins with the use of topical medication which lowers intraocular pressure. Within the past year, two new topical medications have been approved for the treatment of glaucoma: VYZULTA™ and Rhopressa®. VYZULTA™ is a modification of a current class of medications currently used to treat glaucoma – the prostaglandin analogs. This drug helps lower intraocular pressure by increasing the drainage of fluid (aqueous humor) from the eye.
Rhopressa® is part of a new class of drugs used to treat glaucoma called rho kinase inhibitors. Rhopressa®, like VYZULTA™, also lowers intraocular pressure by increasing aqueous outflow. Both Rhopressa® and VYZULTA™ are dosed once daily and pose few, if any, systemic safety concerns.
Selective laser trabeculoplasty (SLT) reduces intraocular pressure by stimulating increased outflow of fluid from the eye. A relatively new addition to our treatment options, SLT offers an improved safety profile compared to older glaucoma laser therapies and may lower eye pressure by as much as 20 to 30 percent. It is typically used as the next step in patients whose glaucoma is uncontrolled on medical therapy. Because of its excellent benefit-to-risk profile, however, SLT can sometimes be used in place of medications, especially in patients who have difficulty with their eyedrops.
The goal of minimally invasive glaucoma surgery (MIGS) is to reduce intraocular pressure by enhancing the eye’s own internal aqueous humor drainage system. Some MIGS can be performed as standalone procedures, while others are typically done along with cataract surgery in patients with visually significant cataracts and mild to moderate glaucoma.
There are now a variety of recently FDA approved MIGS available for use in this country. MIGS typically are performed through a small incision in the eye with minimal tissue trauma and offer a favorable safety profile as well as more rapid visual recovery than traditional glaucoma surgery. At UT Southwestern, we offer coverage in all aspects of eye care, so if a patient needs help with other ocular conditions, we can easily connect them with the appropriate sub-specialist.