Ophthalmologists and Trained Anesthetists of Raghudeep Eye Hospital in Ahmedabad India offer Pediatric Services, Cataract Surgery, Glaucoma Treatment, Cornea Treatment, Dry Eye, Low Vision Treatment.
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Latest News
• Shurveer Singh Gold Medal for the Best Film at Ros 2014 held at Kota in September 2014 Award to Dr.Vaishali Vasavada • Glaucoma Convene 2014 successfully conducted at REH • Dr. Vaishali Vasavada has won "Best Paper" of session Award in ASCRS 2014. • Dr. Vaishali Vasavada & Team have won Runners up award in Video Film category in ASCRS 2014. • Dr. Abhay vasavada has received the APAO Susruta Lecture Award in Japan. • Dr Vasavada won APAO Susruta Award on 3rd April 2014 in Tokyo Japan. • Dr. Shail Vasavada & colleagues have won "Best Paper" award in AIOS 2014. • Cataract Colloquium 2013 successfully conducted at REH • Glaucoma Convene 2013 successfully conducted at Raghudeep Eye Hospital• Dr. Lajja Shastri and colleagues awarded Best Paper of the Session for their scientific paper • Dr. Viraj Vasavada and colleagues awarded Best Poster of the Category for their scientific poster presentation. • Dr. Abhay Vasavada and colleagues awarded two prizes : Best of the Best video, and First prize in cataract complications category for their video film "The Road Not Taken" • Dr mayuri khamar awarded the D.B. Chandra award for best paper glaucoma during aios 2012 meeting. • Dr vaishali vasavada awarded the P. Hanumantha reddy award for best paper pediatric during aios 2012 meeting. • Dr viraj vasavada selected for Drm C.S. Reshmi award for best film "many faces of anterior vitreous season 2" during apao aios 2013 meeting • Team REC awarded BEST VIDEO OF THE CONFERENCE AWARD at the APAO meeting in Hyderabad, Jan 2013. Team REC makes number of paper, poster and video presentations during the same meeting. • Team REC Wins Laurels in Milan. At the recently held annual meeting of the European Society of Cataract & Refractive Surgeons (ESCRS) at Milan, Raghudeep Eye Hospital won two awards - 1st and 2nd prize in the Video Film Festival. Congratulations Team REC ! • Annual Phacoemulsification Work-shop Colloquium 2012 successfully conducted at Raghudeep Eye Hospital. • Dr. Richard Kho from Philipines visited Raghudeep Eye Hospital. • Mr Atul Karwal, Joint Director, Gujarat Police Academy. Gandhinagar. visited at Annual Phacoemulsification Work-shop Colloquium 2012. Who has shared his unique experience on the Mount Everest. • Dr. Rasesh Diwan, Medical Director & Anaesthesiologist, Raghudeep Eye Hospital presented “Topical Anaesthetic regime at Raghudeep Eye Clinic, Ahmadabad, India”. at World congress of Ophthalmic Anesthetic at Ankara, Turkey May 2012. • Glaucoma convene 2012 successfully conducted at Raghudeep Eye Hospital.• Raghudeep Eye Hospital branches out at Dholka. Raghudeep Eye Hospital team now offer its services at Dholka in a brand new premises.• Dr. Stefano Gandolfi from Italy visits Raghudeep Eye Hospital.• Team Raghudeep bagged the Best Film Award for its film " Lights Camera, Action" in the general category at the 25th annual meeting of APACRS Shanghai China.
 
 
Dr Abhay Vasavada-Honorary Ophthalmologist of the Governor

Surgical Treatment for Glaucoma

Surgical treatment for glaucoma
Trabeculectomy

One way to relieve the dangerously high pressure in an eye with glaucoma is to make a new drain in the eye, a bypass for the blocked natural drain. This is called a trabeculectomy and takes the form of a “flap valve” which is surgically created in the white part of the eye hidden under the upper eyelid. The eye pressure is relieved because fluid can now drain through the new valve. A trabeculectomy is usually done under local and/or topical anesthesia. An anesthetist administers intravenous medication to relax the patient and reduce the discomfort of the local anesthetic injections. A shot of local anesthetic numbs the eye completely so that it will not move during surgery nor feel any pain. Alternatively, topical anesthetic drops and jell can numb he eye adequately for surgery. If preferred, the anesthesiologist can administer a general anesthetic, keeping the patient asleep for the whole operation. The surgery itself takes 35 minutes to an hour in most cases.

During trabeculectomy-sometimes also called filtration surgery-a piece of tissue in the drainage angle of the eye is removed, creating an opening. The opening is partially covered with a flap of tissue from the sclera, the white part of the eye, and the conjunctiva, the clear thin covering over the sclera. This new opening allows fluid (aqueous humor) to drain out of the eye, bypassing the clogged drainage channels of the trabecular meshwork.

As the fluid flows through the new drainage opening, the tissue over the opening rises to form a little blister or bubble, called a bleb. The bleb is located where the sclera, or white of the eye, joins the iris, the colored part of the eye.

Indications of trabeculectomy

Trabeculectomy is usually done when medicine treatment for glaucoma has failed to reduce the pressure in the eyes enough to prevent damage to a person's eyesight. It does not help to recover vision which is already lost in glaucoma.

Is it a permanent treatment?

The new opening created by trabeculectomy allows fluid to drain under the tissue that lines the eyeball (conjunctiva), where it is absorbed into the bloodstream.This procedure has been shown to reduce IOP and the need for medical treatment.1But many people need another trabeculectomy surgery or other treatments for glaucoma. Trabeculectomy is less likely to be successful in:

Shunts and Tubes

Glaucoma is a disease in which the drainage mechanism of the eye has become blocked. Since an eye normally produces a watery fluid called aqueous throughout life, this fluid has nowhere to go and backs up. This causes a build-up of pressure within the eye which injures the optic nerve. The safest and simplest type of surgery to reduce intraocular pressure is a trabeculectomy, a procedure which makes a flap valve on top of the eye. This allows the aqueous to seep out under this flap valve and be absorbed under the conjunctiva, the clear layer overlying the sclera, and into the bloodstream.

The ExPress mini-glaucoma shunt is a 400-μm wide by 3-mm long, stainless steel device that offers an additional option when treating difficult glaucoma cases. The device shunts aqueous from the anterior chamber to a subconjunctival reservoir in a similar fashion as trabeculectomy, without removal of any sclera or iris tissue. It provides immediate consistent aqueous flow through a 50-μm opening that allows for formation of a posterior, low-diffuse bleb usually limited to one quadrant.This technique has almost completely eliminated the erosion complication and has been demonstrated to have a lower rate of hypotony than trabeculectomy.

The Ex-Press shunt is on the forefront of evolution toward smaller incision glaucoma filtration surgery. Although, there is an added cost to using the Ex-Press rather than trabeculectomy, there are patient safety issues that are provided by the Ex-Press that make the added cost worthwhile. There are fewer return visits to the operating room with the lower rate of hypotony afforded by the Ex-Press. Examples of these benefits include fewer revisions for over-filtering blebs and much less frequent draining of choroidal effusions.

AHMED GLAUCOMA VALVE

Procedure

The AGV implantation is an outpatient surgery and is done under local anesthesia. The procedure takes around 1 hour and is single-staged, as mentioned earlier. The surgeon proceeds similarly for all types of Ahmed Glaucoma Valves.

The glaucoma valve implant is indicated for glaucoma patients not responding to maximal medical therapy, with previous failed guarded filtering surgery (trabeculectomy) or in cases where conventional drainage surgery is unlikely to succeed.

The device works by bypassing the trabecular meshwork and redirecting the outflow of aqueous humor through a small tube into an outlet chamber.

INDICATIONS

Neovascular glaucoma -- glaucoma associated with vascular disease of the eye (often diabetes)
Cases of Uveitis -- acute or chronic inflammation of the eye.
Congenital glaucoma -- often associated with developmental defects of the eye.
Traumatic glaucoma -- glaucoma associated with injury to the eye.
Post surgical glaucoma -- glaucoma due to Silicone used to repair a detached retina.

Cyclocryotherapy

Cyclocryotherapy is a procedure that employs temperatures as low as -112°F (-80°C) to destroy the ciliary body, an organ in the anterior chamber of the eye behind the iris, which produces aqueous fluid.

Cyclocryotherapy is a last-resort treatment for patients in whom conventional medical and surgical techniques to control glaucoma have failed.

However, its effects are not precise. Adequate intraocular pressure control is the goal of treatment. In spite of treatment the intraocular pressure may still be too high in some cases. In other cases, the intraocular pressure may become too low.