Dr. Ahmed: You know, I think since that I was little, I always wanted to be a doctor. Um, and I was always inspired to do something to make a difference in life.

VO: Dr. Ike Ahmed, who is one of the most experienced complex eye surgeons in the world, has been achieving groundbreaking work in the surgical treatment of Glaucoma, a progressive and chronic disease with no cure which is the 2 nd leading cause of blindness globally [1]. Dr. Ahmed and his team are leading the charge within MIGS or minimally invasive glaucoma surgery the first significant breakthrough in Glaucoma treatment in more than 20 years.

Source [1]: https://www.who.int/bulletin/volumes/82/11/feature1104/en/

VO: So, Glaucoma is a chronic condition of the eye. It’s actually the leading cause of blindness in most parts of the world [2]. It’s slowly progressive, so there are no symptoms to this disease, unfortunately. And, if not treated, it can cause blindness over time.

Source [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723712/

Dr. Assaad: My vision is very important in my practice and in my life. I was 40 years old during my first diagnosis. I was pretty surprised because I did not have any member of my direct family that had glaucoma.

VO: In Glaucoma, what happens is that pressure slowly builds up because of blockages inside the eye. This slow pressure increase causes damage to the back of the eye, the optic nerve and the retina. Over time, this causes loss of peripheral vision. First, the peripheral vision is lost. Again, it’s usually very slow. Patients don’t typically pick it up. But slowly, over years, it causes loss of the central vision. At that time, unfortunately, patients can have serious vision loss and that can affect quality of life. So, glaucoma can be treated, fortunately, but we cannot cure the disease. But we can prevent serious vision loss by lowering pressure. Eye drops that can be given multiple times in the day can be used and has been used many times. We have laser approaches to enhance drainage through the natural system. And then we have more invasive surgeries to basically bypass the natural drainage system. Lately, we’ve been now using a lot of minimally invasive approaches. This is a new genre of devices that I think provide
further pressure lowering without some of the risk of more serious eye diseases and surgeries.

VO: Eye drops are often the first choice for treating glaucoma.

Dr. Ahmed: Eye drops can be effective in lowering pressure. Unfortunately, over time, they often become ineffective. But the bigger challenge for our patients, are two issues. One is compliance. It’s hard for patients to remember to put drops in every day. We basically can’t put drops in every day, the disease gets worse [3]. And the other, of course, side effects, so redness, irritation, burning.

Source [3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038505/

Dr. Assaad: It’s always a challenge to remember every night, did I put the eye drops or not. So, I tried my best.

Dr. Ahmed: So, over the last 20 years, we’ve been searching for ways to better lower pressure without relying on compliance and eye drops, and without taking the serious risks of major surgery. This had led to the development of some of these microscopic options and microscopic devices. For example, the iStent is the smallest stent, and the smallest device placed in the human body. It’s designed to naturally improve the outflow through your natural drainage system. And this progress has allowed us to provide options to patients that maybe aren’t tolerating drops very well. Drops aren’t working but maybe the disease is not so severe they don’t need to have major surgery. And that’s where, you know, microinvasive glaucoma surgery, or MIGS, was born. I was very fortunate to be involved in this. I coined the term back about 10 years ago, as an effort to really push forward the field and its intervention in the era of Glaucoma, intervening earlier, and a safer option, while addressing issues around patient compliance and adherence.

Dr. Assaad: I consulted with my ophthalmologist, and he strongly recommended that I do the Glaucoma procedure and surgery with the cataract surgery in the same setting.

Dr. Ahmed: So, one of the important hallmarks of MIGS for glaucoma surgery is to ensure safety. We have 100 studies that have been published around the world, almost half a million implants that have been put in. And so, I think that the safety has been well established over the last 10 years. I think we can really hang our hat on the safety.

Dr. Assaad: I have little stents in both of my eyes. They are made of titanium. I cannot feel them. And I’m very happy and excited not to have to take my eye drops every night.

Dr. Ahmed: Have a discussion with your eyecare provider. If drops are a challenge, if they’re difficult to put in, you’re forgetting, that’s potentially a problem for you in terms of your risk of getting worse. And of course, affecting your quality of life. We have options now. We have laser options. We have microinvasive devices, like the iStent for example, that can be done fairly safely, lower pressure, reduce some of the side effects of drops. I like helping people, so it’s incredible the effect we see. I am so lucky to do what I do. I don’t look at it as a job, I look at it as a hobby. I’m thrilled every day to walk into my office or walk into surgery.

VO: To learn more about recent treatment advances within glaucoma, please speak with your ophthalmologist.