No incision glaucoma treatment: giving patients freedom from pressure

Dr SelemI first heard of the CYCLO G6 from Dr. Joseph Selem, Board Certified Ophthalmologist in Coral Gables.  G6 sounds like an exotic jet plane, like the one Jennifer Lopez puts in her performance contracts, because Jenny- from- the- Block does not fly commercial.  But I’ve learned that this G6 is a laser system that treats a condition called open-angle glaucoma, the most common form of glaucoma, second leading cause of blindness in the world, affecting over 3 million people. It is a very serious disorder, one that typically gets treated with drugs that lower the eye pressure by either reducing the amount of fluid created in the eye or by helping this fluid flow out of the eye. Typically once your ophthalmologist prescribes these meds you can expect to be on them the rest of your life, and the ophthalmologist will want to see you regularly.

I always thought glaucoma was pretty much a controlled eye problem, with plenty of medications and surgical procedures available to prevent people from going blind.  Evidently this is not the case, and many patients struggle with their medication regiment (they forget or misplace the eye drops), or find the cost of the eye medications too expensive to apply daily. According to a 2015 study of 9,290 glaucoma patients, 17% stated that the high cost of their medications made them noncompliant.

Dr. Selem has a well earned reputation at our Center for his caring behavior. He spends quality time with his patients, explains things thoroughly and is a good listener… qualities greatly admired by those who believe the world is moving too fast.   “For my active patients having to be on drops the rest of their lives, plus the side effects are a major issue”, remarks Dr. Selem.

The CYCLO G6 is a new, low energy laser that targets specific cells in the drainage angle of the eye. It  provides finely controlled thermal waves of energy, a procedure called Cyclophotocoagulaton. The average procedure takes 15 minutes, is pain free and can be performed in both eyes while the patient is sedated.  “The expected outcome for this procedure is to reduce the dependency on costly drops, or at least decreasing use to just 1 type of drop, rather than 2 to 3 different drops. It usually takes about 1 month for final results to take effect, however there have been reports that results can be observed in only 1 week”, explains Dr. Selem.  

What I’ve learned about this Glaucoma Laser procedure:

~A Glaucoma patient can be a candidate if at least one eye drop is not producing effects, or if they are having difficulty sticking to an eye med regiment, because of side effects, or medication costs.

~ The procedure requires no incision, and produces minimal or no inflammation post op.

~ Patients can be sedated using block or general anesthesia.

~ Patient downtime is significantly low, due to a short recovery period.

~It is repeatable, if the doctor feels the eye pressure has not decreased sufficiently.

~ It is effective in significantly reducing eye pressure. Studies show a success rate of 75% after 12 months.

~It allows for future treatment options. It does not interfere with a patient’s therapy as prescribed by their ophthalmologist.

~ Medicare and some commercial insurance plans cover the procedure that is commonly performed in a Hospital or Ambulatory Surgery Center, for major safety and patient comfort.

I asked Dr. Selem what does the future of ophthalmology looked like to him. With his usual enthusiasm, he tells me he believes the future of ophthalmology is very bright, thanks to the improvements in technology which are consistently achieving better outcomes and cures for eye diseases. “Improving or prolonging my patients’ eye sight, is my personal definition of success”, he says.   

Ophthalmologists at Coral Gables Surgery Center that perform this procedure are Dr. Gabriel Lazcano, Dr. Fred Mann, and Dr. Joseph Selem.  The CYCLO G6 is FDA approved, and manufactured by IRIDEX Corporation. There are numerous prospective and randomized clinical trials published.  I found the National Institute of Health website a great place to learn about cyclophotocoagulation. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1723661/

As a patient advocate I always told my clients – to listen, ask a lot of questions, get smart about your condition and have plenty of resources that lead to good options. Your doctor should be your partner in this journey.    

For a list of specialties and procedures at Coral Gables Surgery Center visit www.coralgablessurgery.com


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