Virginia Eye Consultants’ board-certified ophthalmologist Dr. Constance Okeke recently completed two new glaucoma surgical procedures: a TRAB360 and a VISCO360. These are the most recent MIGS (minimally invasive glaucoma surgical) procedures on the market, recently FDA approved in December of 2014 through the company Sight Science and commercially available within the last month. Dr. Okeke is the first in the state of Virginia (and Hampton Roads area) to perform the procedures.
The TRAB360 is a glaucoma surgical procedure called a trabeculotomy, which is designed to improve the eye’s drainage system and better manage eye pressure. During the procedure, the TRAB360 can unroof trabecular meshwork (TM), an area thought to be the highest resistance in the eye’s outflow system. Since the technique is capable of unroofing TM up to 360 degrees, there is more direct access to the natural drainage system, which can help to lower the eye pressure to preserve vision. This can be accomplished in a way where there is a much lower risk of complications compared with traditional glaucoma surgery, and there is no change in the shape of the eye.
The VISCO360 is a viscocanalostomy glaucoma surgery with an internal approach. Originally this surgery has been performed with an external approach, takes a significantly longer time to perform and is a very difficult surgery to master. With the VISCO360, the approach is internal through the same small corneal incision as in cataract surgery, making it a much faster and less risky procedure with the ability to lower the eye pressure. Its purpose is to dilate the outflow collector channels with viscoelastic, a jelly like substance, and allow for an enhanced release of fluid through them, thus lowering eye pressure.
Both procedures have disposable, single-use instruments, which are introduced into the eye through a clear corneal incision, just as in cataract surgery. The procedure can be done in phakic or pseudophakic eyes, combined with cataract surgery or standalone. The procedure typically takes 5-10 minutes to do or less.
Dr. Okeke is a pioneer of the MIGS procedures (Trabectome and iStent) and has contributed to teaching hundreds of physicians on her techniques of surgical skills and management. Along with all the doctors at Virginia Eye Consultants, Dr. Okeke continues to explore state-of-the-art options for the best way to manage and treat the growing glaucoma population.
To learn more about our advanced glaucoma procedures, or to schedule an appointment with Dr. Okeke, please contact us today.