Surgeries for patients with advanced eye tension (glaucoma) who are unresponsive to drug treatment started at AFSU Health Application and Research Center. Finally, the surgery of our five patients with advanced eye pressure was performed by Assoc. Prof., AFSU Faculty of Medicine, Department of Ophthalmology Member and It was carried out by Glaucoma Unit Manager. Dr. Hamidu Hamisi Gobeka and Assoc. Prof. Dr. Serhat İmamoğlu working in Istanbul.
Assoc. Prof. dr. Gobeka said that they are proud that these surgeries, which could not be performed before in Afyonkarahisar, are performed at AFSU. “At AFSU, various glaucoma surgeries can be performed, especially trabeculectomy, drainage implant surgery or seamless microinvasive glaucoma surgeries such as gonioscopy-assisted transluminal trabeculotomy (GATT) and Kahook dual blade (KDB). “This way, patients with advanced eye pressure do not have to go to other provinces.” he said.
Assoc. Prof. Dr. Gobeka said, “We would like to thank our Rector, Prof. Dr. Nurullah Okumuş, our Dean of the Faculty of Medicine, Prof. Dr. Necip Becit, our Chief Physician, Prof. Dr. Ahmet Ali Tuncer, and the Head of the Department of Ophthalmology, Assoc. Prof. Dr. Mustafa Doğan, for providing us with every resource to offer better healthcare services to the public at AFSÜ.”
Assoc. Prof. Dr. Gobeka answered our questions regarding treatment methods and surgical procedures for glaucoma.
What is Glaucoma?
The optic nerves are responsible for carrying the images we see to our brain. Glaucoma, commonly known as “Eye Pressure” or “Blackwater Disease” among the public, occurs when the intraocular pressure remains elevated for prolonged periods, causing damage to the optic nerves.
How is Glaucoma Treated?
Since glaucoma progresses slowly, it often goes unnoticed until later stages. Glaucoma is the most common cause of vision loss, and because there is no definitive cure, lost vision cannot be restored. Treatment focuses on slowing down or delaying the progression of the disease, which is why early diagnosis and treatment are crucial.
There are various treatment methods for glaucoma, depending on the course of the disease and the condition of the eye. Therefore, regular check-ups with an experienced doctor are essential to monitor the eye’s condition, and the treatment process is shaped based on the patient’s response to treatment.
What are the Surgical Approaches for Glaucoma?
If the patient’s intraocular pressure does not decrease despite medication and/or laser treatment and the disease continues to progress, surgery is usually the next treatment option. Depending on the stage of glaucoma and the condition of the eye, the doctor may apply one of several surgical techniques.
One of the primary surgeries, which aims to drain the eye fluid into external blood vessels, is called trabeculectomy. This procedure involves creating new, thin channels in the eye wall to allow the fluid that cannot be sufficiently drained inside the eye to be filtered into external blood vessels.
This surgical method, which is typically performed under local anesthesia and sometimes under general anesthesia, has been widely practiced for years. It is a highly effective technique with well-known results and complications. Though it is often perceived as a single type of surgery, the doctor can modify the procedure based on the condition of the specific eye. It is also possible to perform this surgery in conjunction with cataract surgery.
There are also modern implants aimed at facilitating the drainage of eye fluid. Instead of the mentioned small channels, very fine tubes made from various materials are inserted into the eye to carry out this function.
What is Minimally Invasive Glaucoma Surgery (MIGS)?
Minimally invasive surgical techniques, also known as MIGS, involve directing the fluid inside the eye into the eye’s own drainage channels using various methods, with or without implants. These procedures typically allow the eye to heal more quickly, and in suitable cases, they can yield highly promising results. However, their effectiveness may not always match that of trabeculectomy surgery. Before the surgery, patients are informed about the advantages and disadvantages of the chosen method. One common way these methods are applied is in combination with cataract surgery.
One notable procedure is Gonioscopy-Assisted Transluminal Trabeculotomy (GATT), which is a stitchless glaucoma surgery first performed in the U.S. in 2014. Unlike traditional trabeculectomy surgeries, GATT lowers or halts the rise in eye pressure without making incisions or stitches in the outer layers of the eye, such as the conjunctiva and sclera.
Another approach involves the Kahook Dual Blade, an independent trabectome blade used in ab-interno procedures. This technique, similar to Schlemm’s canal surgeries, allows for a temporal approach with the help of gonioscopy to visualize the nasal angle region. The trabecular meshwork is shaved and removed in strips using micro-forceps, resulting in a significant reduction in eye pressure.
What is Drainage Implant Surgery?
In drainage implant surgery, also known as the seton or tube surgery, an implant made of silicone is placed inside the eye. This implant consists of a thin tube part placed within the eye and a reservoir part placed between the layers outside the eyeball. It works by draining the eye fluid into the capillaries outside the eye, effectively controlling intraocular pressure. These implants are made from materials compatible with the eye and are designed to remain permanently in place.
Güncelleme Tarihi: 5 Şubat 2025
