Glaucoma implants: procedures, goals, and side effects

Definition

What are glaucoma implants?

A glaucoma implant, also known as a glaucoma drainage device, is used to inhibit or even stop the progress of glaucoma. This effort is made so that the patient's condition does not lead to blindness. Glaucoma implants work by removing fluid from the eyeball. This will reduce the pressure on the eyeball.

The cause of glaucoma itself is increased pressure on the eyeball. Eyeball pressure (also known as intraocular pressure) increases due to the buildup of fluid in the eye. This buildup of eye fluid then presses on the nerves until it eventually causes damage to the visual nerve.

Although it cannot be cured, the causes of glaucoma can still be controlled, thereby reducing the risk of permanent blindness. Generally, this condition is treated with medication if the condition is not severe.

If various glaucoma treatments fail to improve the patient's condition, the doctor will generally recommend surgery. Apart from lasers and trabeculetomy, glaucoma implant surgery is now one of the existing alternatives to treat glaucoma.

Although it cannot restore the patient's vision 100 percent, glaucoma implant surgery is claimed to be able to restore the patient's vision by up to 80 percent.

Glaucoma implants come in different shapes, materials and sizes. Currently, there are 2 types of implants that are most commonly used, namely valved implants (valved) and valveless (nonvalved).

When do I need to undergo this procedure?

This procedure cannot be performed in cases of mild glaucoma. This implant is intended for patients with difficult cases, such as failed trabeculectomy surgery or drugs are not able to help optimally.

In addition, glaucoma conditions due to high blood pressure, diabetes, and surgery in certain parts of the eye, such as the retina and cornea, are also cases that can be treated with implants.

Another case in which the patient's condition was suspected of having failed the operation from the start, is another difficult case that can only be managed by inserting the implant. Generally, glaucoma that occurs as a result of post-accident trauma is a case where surgery will fail.

Process

What should I do before receiving glaucoma implants?

Glaucoma implants can indeed improve vision very well. However, keep in mind that not everyone can perform this procedure.

Before deciding whether a patient needs implants or not, there are several things a doctor should do, including:

1. Seeing the patient's condition

Not all patients need implants. That is why, a doctor will determine whether the patient needs glaucoma implants or not.

Patients with congenital glaucoma may need this procedure. The doctor will first suggest other treatments before deciding to use the implant method.

2. Clinical trials

Doctors must perform these steps to increase the percentage of successful implant surgery. One of the things that must be considered is the condition of the patient's conjunctiva, whether it is possible to insert an implant.

If the conjunctiva in the eye of a glaucoma patient is damaged, implant placement cannot be done.

3. Selection of implants

The materials used for implants can differ from one another. Generally, certain ingredients tend to be less expensive than others.

In addition, the size and shape of glaucoma implants can also vary. The doctor must be able to determine the size and shape of the implant according to the patient's condition.

How is the glaucoma implant inserted?

The implant insertion process will usually take place in a hospital and take about an hour. Here is the process you will go through.

1. The doctor will give an anesthetic or anesthetic to the eye and its surroundings, so you will not feel pain during the implant placement.
2. The doctor will make a small, sac-like incision at the bottom of the conjunctiva. It is in this small pocket that the implant will be inserted.
3. A small tube will be inserted into the eyeball through this implant so that the fluid that has accumulated in the eyeball will come out.
4. Eyeball fluid will be flowed through the small tube to the eye area which is behind the implant. This fluid is then reabsorbed by the body, thereby reducing pressure on the eyeball due to fluid buildup.
5. After the implant placement is complete, the doctor will put on the blindfold, which you will need to wear until the next day.

What should I do after undergoing this procedure?

In the recovery process after implant placement, there are several taboos that you should avoid, such as:

• Don't do strenuous activities for a while.
• It would be safer if the patient does not drive the vehicle after implant surgery.
• Take the medicine regularly as directed by your doctor, even if you have implanted.
• Avoid dusty areas.
• If you have to clean the house, clean the dust with vacuum cleaner .
• Don't rub your eyes. Even when the patient is not undergoing medication or surgery, rubbing his eyes is not a good idea as it can lead to infection.
• Do not swim, avoid contact with water in the early stages of the postoperative recovery period.
• Avoid using eye makeup.

After a glaucoma patient's eyes are implanted, it does not mean that the patient is free from using glaucoma medications to treat this disease. Everything still depends on the patient's condition.

There are some cases that require additional treatment. However, if the eye pressure is resolved properly with the use of the implant alone, the patient does not need to take medication or undertake other accompanying treatments.

Although there are some restrictions, glaucoma implant placement is relatively safe. You also don't need to do special glaucoma implant treatment, apart from checking regularly with your doctor. You need to at least undergo routine control every 3-4 months.

The glaucoma implant is permanent and stays in the patient's eyeball for life. Patients also do not need to replace with new implants or remove them at any time. Therefore, maintenance of implant devices must be carried out regularly to maintain the condition of the implants and the patient's eye health.

Side Effects and Complications

What are the side effects and complications of glaucoma implants?

Although it is relatively safe and does not require special treatment, it does not mean that glaucoma implants do not have side effects. The term implant itself indicates that a foreign object has entered the body. This method may have mild side effects in some patients.

The risk of side effects increases if the patient has an allergic reaction to the base material of the implant. However, in practice, the number of patients who experience side effects is less than those who do not.

According to the website of the American Academy of Ophthalmology, here are some of the side effects that may occur after placing an implant in the eye:

• Eye injury, or injury to the inside or surface of the eyeball
• Eye infection
• Bleeding into the eye
• Eye pressure is too low (hypotonia)
• Cataract
• Double vision
• Requires other glaucoma surgery or implant removal
• Blindness

If you have questions, consult your doctor for the best solution for your health.