Dr. Preschel offers an array of advanced glaucoma treatments and has helped many Miami glaucoma patients preserve their vision. His medical team work hand-in-hand to develop the most effective and quick-acting glaucoma treatments, which may include medications in the form of eye drops, minimally invasive laser therapy, eye surgery or the surgical implantation of glaucoma drainage devices.
Prior to treating your glaucoma, Dr. Preschel and his staff needs to know:
• If the patient has a family history of diseases of the bloodstream
• If the patient is allergic to any medications
• If the patient is currently taking prescription medication
• If the patient is taking nonprescription medications.
• If the patient is pregnant or intending to get pregnant.
• If the patient is breast feeding.
• If the patient has asthma or respiratory problems.
• If the patient has heart, liver of kidney problems.
At Premium Eye Centers, a number of medications are currently in use to treat glaucoma. Dr. Nelson Preschel may prescribe a combination of medications or change your prescription over time to reduce side-effects or provide a more effective treatment. Typically, medications are intended to reduce elevated intraocular pressure and prevent damage to the optic nerve.
Selective Laser trabeculoplasty is an office-based procedure performed to lower eye pressure in patients with open angle glaucoma. Patients whose eye pressure is still too high even though they are already on 1 or more eye medications or are intolerant to some of the eye drops due to allergy or other side-effects are good candidates for laser trabeculoplasty. In some patients, laser trabeculoplasty is an acceptable first option for treatment instead of eye drops.
Trabeculectomy is a surgical procedure performed by Dr. Nelson Preschel, a Miami glaucoma specialist, used to lower eye pressure. The mission of trabeculectomy surgery is to provide an accessory drainage pathway for fluid from inside the eye. By trying to lower the eye pressure damage can be halted from further pressure increases but that damage already done is not reversible. The trabeculectomy procedure involves the surgeon creating a tiny passageway from the inside to the outside of your eye. This helps fluid drain better from the areas it is presently not draining. A trabeculectomy can lower the pressure in your eye and help prevent more damage to the optic nerve. Trabeculectomy is more commonly used after other treatment options have not been successful or are simply not stopping the increasing IOP. (Intraocular Pressure)
Glaucoma drainage devices are designed to route fluid from the anterior chamber of the eye to an external reservoir. The device allows a fibrous capsule to form a few weeks following surgery to regulate flow. Glaucoma drainage devices have been used for about 30 years and have been improved for maximum success and intraocular pressure control. They are also used as an alternative if previous treatment, such as a trabeclectomy, has failed or caused scarring. One of the newer and most successful types of GDDs is a Baerveldt implant. This type of implant, or "shunt", is available in three models, all of which provide a large surface area and streamlined design.
iStent® is the smallest medical device ever approved by the FDA, and the smallest device to be implanted in the human body. It is placed in your eye during cataract surgery and is so small that you won’t be able to see or feel it after the procedure is over.
iStent® is designed to create a passageway in your trabecular meshwork (the primary blockage site), and works continuously to improve the outflow of fluid from your eyes to help control intraocular eye pressure. It is a minimally invasive procedure that comes with a rapid recovery time and is a permanent solution to stubborn glaucoma.
Trabectome surgery increases the amount of fluid exiting the eye. The tip of the Trabectome removes the strainer-like tissue (trabecular meshwork) that reduces flow into the natural drainage system. This is done through the same small corneal incision as cataract surgery.
The field of MIGS is also known as Micro-Invasive glaucoma surgery. This is great news for patients that have glaucoma and need cataract surgery. A micro-stent, which is the size of small eyelash can be placed into the eye to work as drainage system. This stent is used to lower intraocular pressure to relieve glaucoma from causing permanent vision loss.
ECP is a laser procedure performed alongside or after cataract surgery and is used to eliminate or reduce the need for other glaucoma medications, such as eye drops. ECP lowers intraocular pressure by decreasing fluid production. Once the cataract is removed from the eye, the ECP probe is entered into the same micro-incision created during cataract surgery. The ECP's tiny fibers direct laser energy at the ciliary processes, which is what produces the eye's fluid, to lower intraocular pressure. This treatment option is minimally invasive and is known to be effective at controlling glaucoma.