Crescent-News.com - Eye shunts bring relief for those with glaucoma

By JEFF RAYMOND

The Oklahoman

The black cloak starts at the margins and creeps toward the center of the eye.

If untreated, glaucoma and its characteristic tunnel vision can lead to blindness.

But tiny, tack-shaped shunts that allow proper drainage are bringing relief to patients with the degenerative eye disorder.

Glaucoma is the second leading cause of blindness in the United States and affects some 3 million Americans. The American Glaucoma Society estimates 120,000 are blind from the most common form of the disease.

Larry Kettler's golf game led to his diagnosis. The retired Oklahoma City police officer couldn't see the balls he had hit down the course.

Although he knew glaucoma runs in his family, he didn't go to the eye doctor as often as he should have.

"I fooled around and didn't get checked for several years," he said. "It was way out of control."

Kettler, 59, blamed migraine-like headaches on his sinuses, never thinking excessive eye pressure was to blame. He even had sinus surgery. The headaches continued for about two years, until his eyes were treated.

An optometrist noticed he had glaucoma and sent him the same day to Dean McGee Eye Institute.

Kettler was lucky. Ophthalmologist Steven Sarkisian Jr. placed a shunt in his right eye in December.

His right eye has a small, off-center blind spot but otherwise is fine. He uses drops to control pressure in his left eye. "I still have fairly good vision in my right eye," he said.

Although not all glaucoma patients have elevated pressure in the eye, it is common. Vision loss is incremental. By the time many people seek help, the damage is done.

"The damage is, in many people, directly related to the pressure," said Sarkisian, one of three doctors in the state who implant the shunts.

Shunts are the best option for patients who don't respond to medication or laser surgery, he said.

Shunts reduce complications and recovery time over trabeculectomy, a procedure that involves removing a small amount of tissue in the eye and part of the iris to allow unimpeded drainage.

Implanting a shunt takes Sarkisian 15 to 30 minutes. He cuts a tiny slit in the iris and then uses a needle to place the shunt under the flap of tissue.

No tissue is removed when placing the eye shunt.

"Everybody is moving toward smaller and smaller incisions, more predictable results," Sarkisian said.