Quit Your Glaucoma Eye Drops After Cataract Surgery

Often, implanting tiny device makes this possible

If you have glaucoma and you’re planning to have cataract surgery, a new innovative type of glaucoma surgery might help you — potentially replacing the need for eye drops if you use them to prevent further vision loss.

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During cataract surgery with minimally invasive glaucoma surgery (MIGS), a surgeon implants a tiny device after removing the cataract and implanting a clear lens implant. The device helps to keep the pressure in the eye normalized, often eliminating the need for drops that do the same thing.

“Approximately one in five patients affected by cataracts takes eye drops for glaucoma on a long-term basis,” says ophthalmologist and cataract surgeon, Aimee Haber, MD.

“In most cases, cataract surgery with MIGS is covered by insurance. On average, three out of four people who undergo the procedure are able to stop using glaucoma eye drops.”

Is MIGS right for you?

Many ophthalmologists recommend MIGS for people with mild to moderate open-angle glaucoma who also have cataracts, Dr. Haber says.

Open-angle glaucoma is the most common form of glaucoma. Other types of glaucoma affect a small minority of those who have glaucoma.

How does the MIGS procedure work?

After removing the cataract and implanting an artificial lens, the surgeon will implant a device to improve fluid outflow that’s so small it’s hard to see with the naked eye. One such device is the iStent®, which Dr. Haber says the FDA approved in 2012.

“The iStent is inserted into the natural drainage structures of the eye,” she says. “You won’t see or feel it after surgery.” It helps reduce the pressure in the eye, which lowers the risk that glaucoma will worsen.

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Does the procedure pose any risks?

“Modern cataract surgery is extremely safe and results in an improvement of vision in more than 95 percent of people,” Dr. Haber says.

“Published studies and my personal experience confirm that iStent surgery combined with cataract surgery is just as safe as cataract surgery alone,” she adds.

Also, post-operative experience and treatment is the same for cataract surgery with or without MIGS.

If you’re already planning on cataract surgery, you won’t need to do anything differently to prepare for or recover from MIGS. In addition, you won’t need to do anything special after you recover, aside from likely stopping your regular glaucoma eye drops.

“There’s no care or maintenance required,” she says. “The iStent is made of titanium and lasts a lifetime.”

What are the benefits of the implant?

The implant offers a variety of benefits, including:

Relief from having to remember to use drops. It’s easy to forget to perform this daily ritual. And, you may require up to four different types of drops for treatment. The implant reduces the risks that come from forgetting to use your glaucoma eye drops.

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Less eye pressure fluctuation. Although your eye pressure should be controlled 24 hours a day, you only take eye drops once, twice, or maybe three times a day. An iStent produces a better continuous eye pressure, lowering effect over the course of the day and night.

Lower costs. MIGS reduces or stops the need for expensive eye drops. “After MIGS, three-quarters of patients don’t need to continue using eye drops,” Dr. Haber says.

How eye exams may detect vision loss from glaucoma before you notice it

Dr. Haber says that the best thing you can do to care for your eyes is to schedule regular dilated eye exams with your ophthalmologist or optometrist.  Your eye care team can often detect glaucoma and other common eye diseases before you are able to notice them.

In the early stages, you may have glaucoma and not know it. Glaucoma typically compromises side or peripheral vision first.

If detected early, treatment can help prevent progression to more significant vision loss that could threaten your ability to drive or perform other daily activities.

At this time, no treatment can restore eyesight that has been lost due to glaucoma, Dr. Haber says. So early detection and treatment is, as is often the case, the best medicine.

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