Tiny New Device Helping Glaucoma Patients

PITTSBURGH (KDKA) — Lori Karavolis, a 49-year-old nurse and mother of four, was in danger of losing her eyesight.

She has a family history of glaucoma, so she would have the pressure inside her eyes checked regularly. Suddenly, she got bad news about the pressure.

“Sky high actually, almost a dangerous level,” she says.

She had no symptoms of this, but she did have worries. “Will I go blind?”

“It’s tough to see patients when they’ve already lost vision, because it doesn’t come back,” says Dr. Jennifer Davis, an ophthalmologist at Southwestern Pennsylvania Eye Center. “It’s peripheral vision loss, almost as a tunnel vision, as it gets to be more advanced. Then, ultimately, it can be full vision loss.”

Regular exams checking pressure and getting a good look inside the eye can catch the condition early.

Glaucoma happens when the fluid in the eye is overproduced or gets blocked and can’t flow out normally through a mesh-like channel. Why the channel gets blocked isn’t known, but there is a hereditary pattern.

The blocked flow results in increased pressure in the eye. This can damage the optic nerve at the back of the eye, causing blindness.

Drops and laser surgery are treatment options, but over time, more drops may be added, and repeat surgery might be needed as the channel closes up again.

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Now there’s a new implanted device called the iStent.

“It, I believe to date, is the smallest medical device implanted in the human body,” says Dr. Davis.

It’s a one millimeter titanium tube that is put in the drainage channel to keep the eye fluid flowing.

“We’ve seen a huge improvement in intraocular pressure after surgery,” says Dr. Davis. “These patients continue to be on fewer drops or no drops, and that’s really the idea.”

It’s meant for people with mild to moderate glaucoma who are also having cataract surgery.

“We do tend to do surgery now earlier than we used to. Cataracts aren’t anymore the older patient disease because we have the technology and the ability to do this with lower risk,” she explains.

Risks include bleeding. The iStent was FDA approved in 2012. Commercial insurers have been covering it.

Lori had her procedure a year ago.

“It’s not painful at all, and you’re back to work or your life the next day,” she said. “I’m doing great. I don’t have to have drops, and just the daily thought of not having that increased pressure. Definitely, the worry’s gone.”

More from Dr. Maria Simbra
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