Micro-Glaucoma Surgery at TEA

Hey there, friends! Today, we’re excited to share some insights on minimally-invasive glaucoma surgery (MIGS) and how we at Ticho Eye Associates personalize the choice of procedure to meet individual patient needs. With the latest advancements in MIGS, Dr. Benjamin Ticho, who has extensive surgical experience with various canal-based devices, ensures you receive the best care tailored specifically to your condition.

Different Varieties of MIGS Procedures

MIGS procedures are designed to lower intraocular pressure (IOP) with minimal tissue disruption. These procedures are categorized primarily into canal-based types, which include stents, goniotomies, and canaloplasty.

Canal-Based Procedures:

•Stents: iStent Inject (Glaukos), iStent Infinite (Glaukos), Hydrus Microstent (Alcon).

•Goniotomies: Kahook Dual Blade (New World Medical), SION (SightSciences), TrabEx (MicroSurgical Technology), or even a simple bent needle goniotomy.

•Canaloplasty: iTrack and iTrack Advance (Nova Eye Medical), Omni (Sight Sciences), iPrime (Glaukos).

Dr. Ticho emphasizes that nearly all glaucoma patients are potential candidates for these procedures unless they rule themselves out based on specific medical conditions or personal preferences. Ticho has extensive surgical experience, including using all of the procedures and devices mentioned above.

Tailoring MIGS to Patient Needs

When selecting the right MIGS procedure, several factors come into play:

•Severity of Glaucoma: The more severe the glaucoma, the more aggressive the intervention needed.

•Intraocular Pressure (IOP): Current IOP levels and the target pressure.

•Medications: Number and efficacy of current medications and the patient’s ability to tolerate side effects.

•Patient’s Tolerance for Risk: Balancing the risk of the procedure with the potential benefits.

For mild glaucoma, less invasive options like the iStent or Hydrus might be suitable. For more severe cases, combining MIGS procedures such as goniotomy with ECP (endoscopic cyclophotocoagulation) may be necessary to achieve the desired outcome.

Recent Studies and Their Implications

A recent study explored whether the pigmentation level of the trabecular meshwork (PTM) or other baseline ocular features can predict outcomes of combined phacoemulsification and MIGS (Phaco/MIGS) in nonuveitic eyes. This study, which included 265 eyes, found that Phaco/MIGS

success was not affected by PTM level but was associated with better pre-op IOP values and greater use of IOP-lowering medications.

Key Findings:

•The high-PTM group had greater mean pre-op IOP (16.7 vs. 15.2 mm Hg) and more cases of primary open-angle glaucoma (POAG).

•Surgery resulted in IOP reduction of 6.5% in the low-PTM group and 13.4% in the high-PTM group.

•The number of IOP-lowering drugs was reduced by 34.6% in the low-PTM group and 18.1% in the high-PTM group.

•Surgical success rates were similar in both groups, highlighting the importance of pre-op IOP and medication use in predicting outcomes.

Advanced Technology at Ticho Eye Associates

At Ticho Eye Associates, we pride ourselves on using the most advanced technology to provide the best possible care. Our latest model OCT and OCT-A machines enable us to evaluate and manage our glaucoma patients with precision and accuracy.

Experience Comprehensive Eye Care with Dr. Ticho

Dr. Benjamin Ticho’s expertise with all canal-based devices ensures that our patients receive personalized, effective treatment plans. Regular eye exams are crucial for detecting changes in optic nerve head capillary density and retinal nerve fiber layers, particularly for those with glaucoma or at risk of developing it. Early detection and treatment can prevent significant vision loss.

Schedule Your Appointment Today!

Don’t wait until there’s a problem to care for your eyes. Schedule your regular eye exam at Ticho Eye Associates today! We have offices in Chicago Ridge and Tinley Park, IL, as well as Munster, IN. Give us a call at 708-873-0088 to book your appointment.

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Stay healthy and keep your vision sharp. We look forward to seeing you at Ticho Eye Associates!