Endoscopic Cyclophotocoagulation (ECP)
ECP is a new technique that reduces the amount of fluid (aqueous humor) produced in the eye and thus lowers pressure within the eye (intraocular pressure or IOP). This can help patients suffering from glaucoma, a disease where excess fluid puts pressure on the optic nerve and damages vision.
ECP is often performed at the same time as cataract surgery for patients who suffer from both cataracts and glaucoma. Recent studies show that patients who undergo the combined ECP/cataract surgery need fewer glaucoma medications over the long term.
During an ECP procedure, the ophthalmologist inserts a tiny probe with a fiber optic light at the tip into the part of the eye that produces fluid, known as the ciliary body or ciliary process. Laser energy then damages some of these cells so they stop producing fluid. The result is a lower, healthier pressure within the eye. Many patients who undergo ECP will sometimes no longer need eyedrops or other glaucoma medications after treatment.
Dr. Allaman has been performing ECP for over six years and was the first doctor to introduce the procedure to Santa Cruz/Monterey Bay.
Selective Laser Trabeculoplasty (SLT)
Selective Laser Trabeculoplasty (SLT) is performed on patients with open-angle glaucoma. SLT uses a laser to focus light energy on the internal drainage channel of the eye and targets cells in the trabecular meshwork, using a very short application of light. Because SLT uses minimal energy, the surrounding tissue is left undamaged. The treatment allows the drain to work more efficiently, succesfully lowering eye pressure more than 75% of the time. After SLT, your eye pressure may increase over time. By five years, up to 50% of the people treated with SLT experience a rise in ocular pressure. Dr. Allaman will need to continue to monitor ocular pressure and can repeat the SLT treatment if needed.
Laser Peripheral Iridotomy (LPI)
Laser Peripheral Iridotomy (LPI) is performed on patients with angle-closure glaucoma. This procedure is also performed on patients who may be at risk in developing angle-closure glaucoma. As with many medical conditions, it is preferable to treat patients at risk and thereby avoid vision loss. In angle-closure glaucoma, the drainage system of the eye may become partially or completely blocked by the iris (the colored part of the eye). A small hole is made in the iris to create a new way for the aqueous fluid to drain from the eye. The new drainage hole restores the balance between fluid entering and leaving your eye.
Diabetic Retinopathy Laser Surgery
Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). When these weak vessels leak, swell, or develop thin branches, vision loss occurs. Laser surgery is the treatment of choice.
Focal laser coagulation may be recommended for patients with clinically significant macular edema – swelling of the central retina, called the macula. The laser coagulates, or dries up, the fluid that is causing the swelling. A similar procedure called pan-retinal photocoagulation (PRP) destroys abnormal blood vessel growth in patients with proliferative diabetic retinopathy (PDR). This procedure works best before the blood vessels have started to bleed. It can cause a loss of some side vision, but will save the rest of your vision from being lost.
Ptosis is a common condition that can affect the upper eyelid of one or both eyes as a result of aging, a congenital defect, muscle deformity or neurological disorder. This condition can occur in patients of all ages, but is most common in older patients and will likely continue to worsen with age.
Patients may seek treatment for droopy eyelids for cosmetic and/or medical purposes. Severe drooping may obstruct vision as the eyelid gradually droops lower and lower, eventually covering the eye. Other patients are simply bothered by the appearance of their eyelids. Treatment for this condition usually involves eyelid surgery, known as Blepharoplasty. This procedure involves removing excess skin from the upper eyelid.
Punctal plugs can relieve dry eye symptoms when drops or ointments are insufficient. Punctal plugs are placed in the opening of the tear ducts (called “puncta”) in the eyelids to block tear drainage and keep the eyes moist. Implantation should reduce the need for artificial teardrops and increase the patient’s overall comfort.
Punctal plugs come in a few different shapes and sizes, and may be placed in the lower or upper eyelid or both eyelids. The most common plugs are umbrella-shaped and made of silicone. Implantation takes only a few seconds and is performed in our office. In some cases, before implantation, collagen is temporarily placed in the eye to predict the effectiveness of punctal plugs.