Glaucoma is a silent and degenerative disease of the optic nerve, representing the leading cause of irreversible blindness in the Western world. It is characterised by excessive intraocular pressure, which crushes the optic nerve, slowly destroying the nerve fibres that connect the retina to the brain. The reasons for the increase in ocular pressure are still unknown today.
If it is not detected in time, glaucoma results in a gradual and subtle reduction in the field of vision that is often noticed by the patient at a very late stage and, over time, results in vision loss.
Types of glaucoma
- Chronic glaucoma, or primary open-angle glaucoma
- Acute glaucoma, or acute angle-closure glaucoma
- Refractory glaucoma
These diseases often develop without causing any pain or symptoms, which is why regular screening is necessary.
The only way of detecting glaucoma in time is to be checked by an ophthalmologist. This should be every three years from the age of 40 years old. Carried out by doctors specialising in ophthalmology, this painless, harmless test lasts about 20 minutes. The doctor uses a slit lamp that emits a light beam to observe the interior of the eye. They then measure the ocular pressure and examine the back of the eye, which allows them to carefully assess the optic nerve and the retina.
Glaucoma treatment involves reducing the intraocular pressure (not to be confused with arterial pressure). There are three methods for reducing intraocular pressure: eye drops, lasers, and surgery (minimally invasive glaucoma surgery (MIGS), or filtration surgery).
Your ophthalmologist will tell you which approach is most suitable for preserving your vision for as long as possible and best for your current situation.
A glaucoma operation cannot cure glaucoma, or improve visual function, or repair irreversible lesions caused by glaucoma. The purpose of glaucoma surgery is to reduce the intraocular pressure in order to slow down, or even stop, the development of glaucoma by creating an alternative drainage channel.
- Filtration surgery: This involves providing drainage between the anterior chamber and the scleral space or subconjunctival space. In some cases, it may be necessary to insert mechanical means (implants) or chemical means that facilitate filtration. There are two recognised techniques, the first being trabeculectomy, which involves removing a small part of the trabecular filter, requiring the eye to be open during the intervention, and the second being deep sclerectomy, which involves only removing the external part of the filter, without the eye being open.
- Baerveldt tube surgery: This involves opening a flap in the sclera (the “white” of the eye) in order to insert a Baerveldt implant. This is a silicone tube allowing the aqueous humour to be drained from the anterior chamber (part of the eye between the cornea and the iris) into the orbital space, behind the eye. The tube is connected to a plate, also made of silicone, which has the special property of being curved, so that it can be easily positioned on the eyeball. This plate is fixed behind the eye, which allows the aqueous humour to be drained into this orbital space.
- The eyeWatch : Developed in Lausanne by the start-up Rheon Medical and Professor André Mermoud, the eyeWatch is a microscopic device, that is implanted directly in the eye. It looks like a tiny tap, which can be adjusted remotely using a magnetic disc. Used in the treatment of refractory glaucoma, it helps control the amount of fluid present in an eye affected with glaucoma.
The choice of intervention depends on the criteria linked to your glaucoma, which only your ophthalmologist can assess.
eyeWatch, un implant oculaire unique
Inventé à Lausanne au sein de l’EPFL et en collaboration avec le
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Inventé à Lausanne au sein de l’EPFL et en collaboration avec le Professeur Mermoud à la Clinique de Montchoisi , l'eyeWatch est un tube de drainage microscopique utilisé dans la chirurgie du glaucome afin de contrôler la pression intra-oculaire. Conçu en matériaux biocompatibles, ce dispositif novateur, implantable directement dans l’œil et comparable à un micro-robinet, est réglable à distance grâce à un disque magnétique.