Glaucoma surgeries are taking more and more primacy today in treatment of this still mysterious eye disease, especially with the patients who have been on local therapy with drops for many years, or with whom applying the drops causes the allergy reactions on eye surface.


Glaucoma surgeries were applied rarely before, only when the local therapy was not sufficient to control the intraocular pressure. The surgeries were invasive, with a high probability for development of post-operative complications that could even result in a total loss of vision.


The present-day glaucoma surgeries represent one of the safest types of eye surgeries. With the help of filtration implants, such as Ex-Press glaucoma shunt, the control of the eye pressure is continuous, and over 95% of patients after the surgery do not have to use any additional therapy in the form of drops to normalize the eye pressure.

ex press shunt šant

The Ex-Press glaucoma shunt is currently the most modern and the least invasive implant that normalizes the intraocular pressure values. The implantation procedure itself is simple, is done in topical anesthesia (anesthesia with drops), and the patient leaves the clinic immediately after the surgery. The effects of the surgery are visible within 2 or 3 days after the operation, and its size, which is smaller than a finger tip, does not prevent the normal functioning of the eye.


Ex-Press glaucoma shunt has proved to be the best and safest surgical method for high intraocular pressure correction, and has been available in our clinic too for several years alreadyV.


Glaucoma is an optical nerve disease developed as a consequence of non-regulated eye pressure. It results in vision field narrowing, weakening of vision acuity and in most difficult cases in permanent vision loss. It is the second cause of blindness in the world, immediately after the macular degeneration. However, there are more and more statistical data that define glaucoma as the leading cause of blindness. It is not easy to diagnose it because most frequently it is an asymptomatic disease, so it is rightly called a silent thief of sight. The main division is to open-angle and angle-closure glaucoma, as well as to primary and secondary glaucoma.

Glaucoma may be diagnosed in all age groups, including the new-born or very small children. It is equally found with the young people as well as with the middle-age group. It is however most frequent in an advanced age. It is hard to recognize. Even in the developed countries with routine programs of early glaucoma detection, 50% of cases remain undiagnosed.


The causes behind a disorder in running of the eye liquid, which in turn leads to the pressure on the eye nerve and its constant deterioration, are mainly unknown. A group of patients with whom the reasons for an elevated eye pressure may be defined is smaller, such reasons including eye apple injuries, certain diseases such as diabetes, etc.


Symptoms are mostly completely lacking. The patients often mention quite atypical symptoms such as tears from the eyes, occasional headaches accompanied with blurring of vision, sensitivity to light, and haloes in the form of rainbow colours around the watched source of light.


The eye pressure which is defined as a risk factor for glaucoma development is the one exceeding 21.00 mmHg, and certainly elevated if exceeding 24.00 mmHg. However, there are also glaucomas with which the intraocular pressure is not necessarily elevated, and it is referred to as normotensive glaucoma and glaucoma with low values of intraocular pressure. Also, an increased loss of nerve fibres at the head of optic nerve referred to as excavation is a suspicion of the existence of glaucoma.


The development of glaucoma in the family does not mean that all its members will develop it but that a possibility of occurrence of the disease is higher compared to the families without glaucoma. This is certainly an indication for bigger caution and more frequent checks of intraocular pressure.


High shortsightedness bears an increased risk of glaucoma, like the previously mentioned diabetes. Hypothyroidism may also lead to the development of glaucoma. Vascular diseases and arterial hypertension may lead to weaker nutrition of the optic nerve due to the therapy used to treat it.

In order to diagnose glaucoma, the basic thing is to take a detailed personal and family medical history of the patient, check the visual acuity, measure the intraocular pressure, examine the ocular angle, measure the thickness of cornea and examine the eye fundus with a special emphasis on the appearance of the optic nerve. If possible, optical coherence tomography (OCT) should be done. It is certainly necessary to test the field of vision which shows us the condition of PNO.


Treatment of glaucoma is primarily done by applying the anti-glaucoma drops in the eye. This is a lifetime therapy, but it is the best while glaucoma can be regulated in this manner. In that, the doctor must take into account the general medical condition of the patient and based on that prescribe appropriate drops. If that therapy is not sufficient, it is combined with laser therapy. It includes argon laser, Yag laser and, something that has been largely applied lately, the selective laser trabeculoplasty (SLT). Which of these lasers will be applied depends on the type of diagnosed glaucoma. Numerous operations are considered as the ultimate way of treating glaucoma. They, however, most frequently are not a permanent solution, so they are resorted to when none of the previously mentioned methods is enough anymore. In any case, glaucoma is a disease which, despite all therapies, advances until the end of life. But, when it can be managed by a therapy, the progression of the disease is very slow, so that such patients have a very optimistic prognosis without a fear of permanent loss of vision. See the most frequently asked questions of the patients.




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