Navigation Links
Glaucoma Treatment Can Prevent Blindness
Date:7/2/2008

Even those with severe disease can save some vision, experts say

WEDNESDAY, July 2 (HealthDay News) -- Glaucoma doesn't necessarily have to end in blindness, two new studies suggest.

In one report, researchers say they found traditional surgery for glaucoma has better outcomes than using glaucoma drainage devices. The second report found that even patients with end-stage glaucoma can be successfully treated. Both studies were published in the July issue of Ophthalmology.

In the first report, researchers looked at the number of complications from traditional glaucoma surgery versus complications from inserting a device that drains fluid from the eye.

"We found a higher complication rate for glaucoma drainage devices than for traditional surgery," said lead researcher Frank Sloan, the Alexander McMahon Professor of Health Policy and Management at Duke University. "Of course, adverse outcomes for either procedure are rare."

In deciding between the two procedures, physicians will have to balance the risks versus the benefits, Sloan said. "It's good for ophthalmologists to have these outcome rates in mind when they counsel patients," he said.

In the study, Sloan and his colleagues collected data on 14,491 Medicare patients with glaucoma. These patients all underwent one of three surgeries. These included primary trabeculectomy (PT), trabeculectomy after scarring from previous surgery or trauma (TS), or the implanting of a glaucoma drainage device (GDD).

All these surgeries are designed to improve the drainage of fluid from the eye and reduce intraocular pressure. In trabeculectomy, a small portion of the tissue at the base of the cornea is removed to increase fluid flow, and in GDD a tiny shunt is implanted, which redirects fluid flow.

Sloan's group found that all of procedures had few adverse outcomes. However, GDD resulted in more patients progressing to low vision or blindness (2.6 percent), compared with patients who underwent PT (1 percent) or TS (1.3 percent).

Dr. Robert Cykiert, an ophthalmologist at New York University Medical Center and a clinical associate professor of ophthalmology at New York University School of Medicine in New York City, said that this study "says that one should try trabeculectomy procedure first, if you can."

In these patients, "experience and intuition says that additional trabeculectomy surgery usually won't work. That's why we go to a glaucoma drainage device," Cykiert said. "This study indicates that if there's any belief you can get away with doing a trabeculectomy procedure, you are better off doing that then putting in the drainage device."

These results will make people a little more conservative, Cykiert said. "Some glaucoma specialists jump ahead to the glaucoma drainage device sooner than they might or should," he noted.

In the second study, Dr. Jason W. Much, from the Department of Ophthalmology at the University of Virginia in Charlottesville, and his colleagues looked at the charts of 64 patients with end-stage glaucoma. All these patients were considered legally blind at the start of the study.

All patients underwent trabeculectomy or laser trabeculoplasty, where tissue is removed by laser. The researchers found that, despite impaired vision, these patients did not become blind.

"Relentless progression to [complete] blindness is not the norm in treated patients," Much said in a statement. "Patients should be encouraged that treatment is not futile. They may retain their visual acuity for many years and be able to perform simple tasks of daily living and enjoy reading and hobbies."

Cykiert said this study contradicts what has been thought for a long time. "The thinking has been that treating patients with end-stage glaucoma is often unsuccessful, because they wind up losing their vision," he explained.

The conventional wisdom has been that once optic nerve was damaged beyond a certain point, no matter what one did, the nerve would eventually die, Cykiert said.

"This study shows that's not the case, even people with end-stage glaucoma, if you treat them aggressively and follow them carefully, you can preserve that little amount of vision that's left," Cykiert said.

Glaucoma is a disease that damages the optic nerve, which if untreated will eventually lead to blindness. Glaucoma is detected by an intraocular pressure test. When the pressure climbs above 21 millimeters of mercury, glaucoma is present.

There are several types of glaucoma. The most common in the United States is called primary open-angle glaucoma. In the United States, many people have ocular hypertension, which is a precursor to glaucoma. Ocular hypertension results in elevated fluid pressure in the eye, but no damage to the optic nerve or vision loss.

Blacks and Hispanics are at higher risk for glaucoma, and progression to end-stage glaucoma is very common among blacks.

More information

For more on glaucoma, visit the U.S. National Library of Medicine.



SOURCES: Frank Sloan, Ph.D., Alexander McMahon Professor of Health Policy and Management, Duke University, Durham, N.C.; Robert Cykiert, M.D., ophthalmologist, New York University Medical Center, clinical associate professor, ophthalmology, New York University School of Medicine, New York City; July 2008, Ophthalmology


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Fluctuating eye pressure associated with visual field deterioration in glaucoma patients
2. Glaucoma surgery in the blink of an eye
3. Glaucoma surgery in the blink of an eye
4. Chair of U.S. Preventive Services Task Force Pledges to Recommend Re-evaluation of Recent Glaucoma Findings
5. Looking at Glaucoma as a Systemic Disease
6. Cost of glaucoma medications may impact treatment
7. January is National Glaucoma Awareness Month
8. Upcoming meeting will explore new technologies for glaucoma clinical drug trials
9. Dr. Welsh Self-Test Diagnoses Glaucoma, the Leading Cause of Preventable- Blindness
10. Mayor Bloomberg Declares March 6, 2008 World Glaucoma Day in New York City
11. Glaucoma May Boost Cardiovascular Death Risk in Blacks
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Glaucoma Treatment <i>Can</i> Prevent Blindness 
(Date:2/11/2016)... ... February 11, 2016 , ... Student-doctors from Western ... (AOA) Match Program Tuesday, February 9, taking one of the final steps in ... medical education positions across the country. Of the 103 student-doctors who comprise the ...
(Date:2/11/2016)... ... 12, 2016 , ... The Journal of Pain Research has seen ... SJR uses data taken from the Scopus database (Elsevier B.V.) and is a measure ... by the journal over a three year period and also the importance of the ...
(Date:2/11/2016)... ... ... Hall Integrative Health and Chiropractic, PC which focuses on ... in March. All seven practices are set to start accepting patients in March ... According to this 2011 CNN article it is possible: http://www.cnn.com/2011/HEALTH/01/28/reverse.diabetes/ . Current ...
(Date:2/11/2016)... (PRWEB) , ... February 11, 2016 , ... ... upcoming Feb. 23 webinar, “Intel’s Direct-to-Employee Benefit Model: A Case Study for Plans ... Catholic health care system that’s partnering with Intel on value-based health benefits program ...
(Date:2/11/2016)... ... , ... PharmMD CEO Robert Yeager announced today ... contract negotiations, corporate strategy and healthcare data law. Additional responsibilities will include healthcare ... breaches for the Part D Star Rating improvement and Medication Therapy Management firm. ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... , Feb. 11, 2016 Brain Cancer ... treatment method at West Cancer Center . ... fields to inhibit cancer cell replication causing death of ... than a decade to show a significant extension in ... (GBM) patients. Currently, West Cancer Center is the only ...
(Date:2/11/2016)... , Feb. 11, 2016  AbbVie, a ... AbbVie Rheumatology Scholarship, designed to provide financial support ... as they pursue higher education goals. Fifteen scholars ... the 2016-2017 school year. The AbbVie Rheumatology Scholarship ... Haas , vice president, corporate social responsibility, brand ...
(Date:2/11/2016)... 11, 2016 PLAD, Inc. (OTC Pink: PLAD) is ... sales exceeding company targets, are adding key personnel to ... from the United States Patent and Trademark Office for ... Executive Officer of PLAD, Inc.  In January, PLAD established ... with two new customers, Cumberland Goodwill EMS ...
Breaking Medicine Technology: