25 June 2019

Sheffield woman praises sight-saving surgery

A Sheffield woman who has suffered with glaucoma for nearly four decades has praised the success of a pioneering new procedure which has seen the pressure in her right eye drop to its lowest level in 35 years, potentially saving her sight.

Jean Billam, 78, who lives in Sothall, described the results of the operation which was undertaken at Sheffield’s Royal Hallamshire Hospital as “absolutely amazing”.

The procedure, which is the first of its kind in Europe, involved the use of a new hi-tech device called a goniotome, which works in a similar way to other minimally invasive glaucoma surgeries, particularly the trabectome procedure which was also pioneered in Sheffield, by draining fluid in the eye to release pressure that could otherwise potentially damage the optic nerve and eventually cause blindness.

However, unlike the trabectome, the goniotome has an advanced dual-cutting mechanism and V-shaped blade which enables surgeons to access the complex structures of the eye without the need of costly high frequency generator. Not only does this save money, but the procedure potentially causes less postoperative inflammation in the eye.

Once the goniotome probe is inside the sieve-like area of the eye known as the trabecular meshwork surgeons can delicately strip away the tissue, and allows them to open up the eye drainage canals so fluid can permeate to the low pressure blood system. This in turn releases pressure in the eye, preventing damage to the optic nerve.

For Jean it’s meant that she now could be doing away with a lifetime’s dependency on eye drops as after surgery the pressure in her right eye dropped from above normal ranges (24mmHg) to the lower end of the normal range (10mmHg). This is the lowest recorded pressure she’s seen in her eyes for 35 years.

“The thing about glaucoma is you don’t know you have it, and that’s why it can be so dangerous,” said Jean, who received regular screening tests for glaucoma at the Royal Hallamshire Hospital after her brother was diagnosed with the condition.

“I wasn’t immediately diagnosed with the condition, but I kept coming back for regular check-ups, and I was eventually diagnosed with the condition too.

“Having the minimally invasive operation with the goniotome device has made a tremendous difference; I’ve never seen the pressure in my right eye so low. Because of the surgery I’ve had I’ve also been able to reduce the number of glaucoma drops I use, and may be able to completely stop if the pressure remains low at my next appointment. The eye drops have been no hardship as I’ve been used to using them for so many years now, but it would be lovely to think I could manage without them, and for patients who have just been diagnosed with glaucoma who aren’t used to using the drops this could be really beneficial.”

Mr Graham Auger, consultant ophthalmologist at Sheffield Teaching Hospitals NHS Foundation Trust, who is the first eye surgeon in Europe to use the goniotome device as part of minimally invasive glaucoma surgery, said: “We are delighted to be offering patients with moderate glaucoma who have previously not responded to first line therapies such as eye drops or laser surgery this new procedure.

“Preliminary data comparing eye pressure measurements from patients before surgery with the goniotome and with postoperative readings demonstrated that all nine eyes of eight patients treated with this device had a significant drop in their intraocular pressure, which is key to preventing fluid build-up and, consequently, blindness.

“Although these are promising results, we now need to gather more data on a larger group of patients to confirm if this device is as effective as other minimally invasive treatments in the management of uncontrolled glaucoma and causes less inflammation. For patients like Jean, however, the treatment appears to have made a great difference.”

Around 480,000 people in Britain suffer with glaucoma, a progressive and irreversible illness which is caused when the optic nerve is damaged by a build-up of pressure in the eye. If untreated, patients begin to lose peripheral vision and go blind. The only proven method to protect eye from glaucoma is to reduce the intraocular pressure; either medically or surgically. The number of glaucoma sufferers in Britain is expected to rise by 44% in the next 20 years.


Photo: Jean with Mr Auger at Sheffield’s Royal Hallamshire Hospital



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