Glaucoma is one of the leading causes of irreversible blindness in the world and is associated with a reduced quality of life. Bahrain Specialist Hospital, recognized as the Centre of Excellence for Eye Care, is the first hospital in Bahrain to introduce an innovative Minimally Invasive Stent Surgery designed to restore the natural physiological outflow through the trabecular meshwork and improve the quality of life of glaucoma patients.
Dr. Swagata Sarkar, Consultant Ophthalmologist at Bahrain Specialist Hospital said, “At the moment, the majority of glaucoma patients are using eye drops to treat their glaucoma. Many of them tend to develop compliance and tolerance issues to their medication due to a combination of various factors. One of the major factors stems from the fact that eye drops need to be used daily, sometimes multiple times throughout the day, and most patients find it difficult to administer the drops at home and miss the eye. These kinds of errors in administration lead to inaccurate dosage and ineffective treatment which can be exacerbated with increasing polypharmacy over the years”.
“Many of the components of intraocular pressure (IOP) -lowering drops are aggressive to the ocular surface and prolonged use of multiple eye drops causes tolerance issues in the long run. Although these may remain almost asymptomatic for quite a long time when dry eye symptoms do develop, they are often treated with tear substitutes, an additive strategy that ends up worsening their underlying condition rather than treating it, particularly if their tear substitutes also contain preservatives. So a disease which itself is largely asymptomatic now becomes symptomatic due to discomfort, redness and stinging in the eyes further inhibiting compliance – necessitating the need for reducing the treatment burden of eye pressure control in glaucoma patients”, further added by Dr. Swagata Sarkar.
Due to the pandemic, many patients have been unable to attend their appointments and procedures with the fear of coming to the hospital. Many of them also faced a sudden shortage of their regular anti-glaucoma medications due to logistic issues caused by the pandemic resulting in poor medication adherence and worsening their eye pressures. Some of the patients who had also scheduled their cataract procedures in the initial months of the pandemic had to cancel causing visual function deterioration; worsening their cataracts during the ensuing year.
“A combined surgery to tackle both cataract and glaucoma in a single sitting in these patients allowed us to not only improve their vision but also get excellent control over their eye pressures, preventing deterioration of their glaucoma. This microinvasive glaucoma surgery makes it a viable alternative for early intervention in those diagnosed with mild to moderate open-angle glaucoma. Interestingly, a few patients with mild to moderate glaucoma have been able to cease medication altogether with excellent control of their eye pressures resulting in reduced postoperative visits thereby keeping them safe at home all while maintaining a small surgical footprint. The additional bonus of improved ocular surface resulting from reduced BAK preservatives in glaucoma eye medications was also very welcome by my patients”, added Dr. Swagata Sarkar.
Dr. Kasim Ardati, Managing Director of Bahrain Specialist Hospital added, “This surgery gives us the golden opportunity of not only having the satisfaction of knowing that our glaucoma patients know that their disease is being safely controlled at all times, and is no longer subject to inconsistencies of compliance, but also we are making a meaningful difference in their quality of life. I would also like to take this opportunity to congratulate the team, particularly, Dr. Swagata Sarkar for introducing this innovative Microinvasive Glaucoma Surgery service which helps to control glaucoma with minimal tissue trauma at our hospital”.
Mr. Majed Ardati, Chief Operating Officer at Bahrain Specialist Hospital commented, “We are excited to be the first hospital in Bahrain to introduce this innovative technology which has the possibility of reducing or eliminating the medication burden for patients who have endured years of administering glaucoma medications and have had to bear with their subsequent side effects”.