Glaucoma surgery


High frequency deep sclerotomy (is a modern surgical method of choice for the treatment of open angle glaucoma , which main features and benefits are innovation and minimal invasiveness .

Intervention is easily applicable and practically painless and is performed under local anesthetic drops.

Intervention achieves a significant reduction in intraocular pressure / IOP / with open angle glaucoma . Using high power bipolar radio - frequency, forming a six-point deep sclerotomy that significantly reduce runoff resistance of aqueous humor from the anterior chamber .

Target areas for the application of deep sclerotomy are primarily located in the nasal part of iridocorneal corner, opposite of temporal corneal incision , which is the place of entry of the probe into the eye.

The intervention can be successfully combined with cataract surgery ( phacoemulsification ) , after positioning the intraocular lens and pupil constriction , at the end of the intervention. Also, HFDS can be easily used as a single procedure . The intervention is performed in the local anesthetic drops , it is practically painless and is performed with the use of modern viscoelastic substances and probes of superior quality .

The procedure is suitable for patients because it is done as a one day surgery. As a rule , one intervention solves the problem of the existence of elevated intraocular pressure . In rare cases when six openings of deep sclerotomy are not sufficient for the regulation of intraocular pressure , implantations may be repeated .

Some of the advantages HFDS intervention is also short duration of the project , the success of the dominant majority of patients , the current efficiency and long-lasting effect of lowering intraocular pressure , as well as a very rare complication. Results are immediate and eye pressure usually continues to decline during the next six months.

European ten-year follow-up studies of lasting control of intraocular pressure after application of this method shows that the vast majority of cases , about 80 % , achieves stabilization and normalization of intraocular pressure without additional therapy with antiglaucomatous drops or other treatment .

Future of ophthalmology is in minimally invasive surgery , whether it be about glaucoma , cataract or retinal surgery , a small surgical incision reduces the period of rehabilitation and improves the chance to meet the patient's wishes and expectations

Experienced surgical team of Milmedic Clinic , led by Prof. Dr. Miroslav Vukosavljević guarantes success of this method.


TTR


Trabeculectomy (filtration surgery) is a surgical procedure that is used in the treatment of glaucoma, open angle or narrow.

It can be combined with medications or laser therapy. As a rule , it causes a significant drop in intraocular pressure.

The point of intervention is the opening of the drainage channel through sclera and conjunctiva below, through which it is possible to relieve some excess for aqueous humor and intraocular pressure is , thus, kept under control.

Filtering cushion is placed up to 12h under the upper eyelid and is completely undetectable. The surgery is performed under local anesthesia and is painless.


Implant placement


In circumstances where glaucoma is not controlled in a satisfactory manner, by pharmacological treatments or drops after laser intervention such as NdYAG laser iridotomy or a Selective laser trabeculoplasty / SLT / and after filtering surgery / trabeculectomy / the solution appears as the use of drainage implants .

Older generation drain implants (Molteno, Ahmed) consisting of a silicone tube with or without a valve, which enable everyone passive swelling of aqueous humor from the anterior chamber in the episcleral space, leading to a reduction in intraocular pressure, and thus, control glaucoma.

A more modern approach, used in MILMEDIC is based on the installation of EXpress ™ mini shunt.It is used in glaucoma that is not adequately regulated by other therapies, as well as uncomplicated glaucoma. The device is placed with valvula under the scleral flap during the modified trabeculectomy intervention.

The surgery typically provides very successfully reduction of intraocular pressure, which is being successfully stabilized in the long-term. The intervention itself is virtually painless and is performed under local anesthetic drops, the same day the patient is discharged home and the effect is achieved almost instantly.

The possibility for the occurrence of complications is minimal, and EXpress ™ mini shunt is made of top quality material which provides to virtually unlimited duration.

Surgical team on MILMEDIC clinic has significant experience in glaucoma surgery, and installation of micro shunt, due to its efficiency, is the method of choice, and we recommend it with confidence.