New glaucoma surgery on the horizon

Last Updated: 2002-05-27 17:00:11 -0400 - NEW YORK (Reuters Health) -
Doctors say that a new surgical technique may one day offer an alternative
to traditional methods for treating the sight-robbing eye disease
open-angle glaucoma.

Open-angle glaucoma is one of the world's leading causes of blindness,
affecting some 33 million people.

In the disorder, fluid pressure builds up slowly inside the eye causing
gradual damage to the optic nerve and impairing vision.

Patients also suffer varying degrees of eye pain, according to the study's
lead investigator, Dr. Jacob A. Dan of the Weizmann Institute of Science in
Rehovot, Israel.

The traditional surgical approach, called trabeculectomy, calls for
creating a pathway, through a series of incisions, by which the extra fluid
in the eye can escape.

The fluid is funneled to another part of the eye where it is then absorbed
into the bloodstream.

The new technique, which is much less invasive, uses an enzyme that can be
"selectively activated on the eye-coat as a 'biological knife' increasing
the porosity of a limited area, thereby allowing a better release of fluid
from within the eye and lowering the pressure of the eye in patients with
open angle glaucoma," Dan told Reuters Health in an interview.

In the preliminary investigation, Dan and colleagues performed the new
procedure on 15 patients blinded by advanced open-angle glaucoma.

The treatment brought down pressure within the eye by 43%, on average,
immediately after it was performed. One year later, pressure continued to
be 20% lower than before the surgery.

And the operation, known as enzymatic sclerostomy, relieved symptoms such
as eye pain in 86% of the patients, according to the study, which is
published in the May issue of Archives of Ophthalmology.

While blindness as a result of glaucoma is irreversible, Dan noted that if
patients are treated early enough the damage of glaucoma can be stopped or
delayed and blindness may be prevented.

Still, Dan and colleagues emphasize in their report that the new technique
is in the very early stages of development and "suffers from several
technical difficulties."

"The authors are to be congratulated for introducing an innovative concept
with potential use in the surgical management of glaucoma," Dr. M. Roy
Wilson of Creighton University in Omaha, Nebraska, writes in an
accompanying editorial.

"Those of us who take care of patients with glaucoma anxiously await the
results of further studies."

SOURCE: Archives of Ophthalmology 2002;120:548-553, 633.
Copyright 2002 Reuters Limited. All rights reserved.

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