Treatment of Glaucoma in Israel

Glaucoma is the second most common cause of vision loss, after cataracts. But unlike the clouding of the lens of the eye, glaucoma leads to irreversible blindness. The vision loss can be prevented by treating the disease as early as possible. The doctors of the medical centers in Israel use laser procedures and surgery to normalize intraocular pressure and prevent damage to the optic nerve. This country offers high quality, safe treatment at an affordable cost.

Principles of treatment for glaucoma

Glaucoma is the syndrome that unites a few dozen eye diseases that lead to elevated intraocular pressure due to the impaired outflow of intraocular fluid (aqueous humor). This gradually leads to a narrowing of the visual fields. Over time, a person will become completely blind if not treated, as the disease causes an irreversible damage to the optic nerve.

Glaucoma can be congenital and acquired, open-angle and closed-angle. The initial treatment involves the use of drugs. They need to be taken regularly.

The stable results can be achieved with laser treatment or surgery. The cost of such treatment is higher. But the need for drugs will be avoided, the intraocular pressure will be normalized for a long time or forever. After the operation a person will be constantly monitored by an ophthalmologist, since the disease can recur after several years.

Glaucoma can be treated with dozens of types of operations and laser procedures. Since there are different types of this disease, different treatment methods are required. In the clinics in Israel, one can cure glaucoma quickly, safely, with lasting results and at an affordable price.

Laser treatment for glaucoma

Laser treatment has been used in ophthalmology for decades. It is usually less effective than a surgery. However, there are also the procedures that can stabilize intraocular pressure, if not forever, then at least for several years.

Here are some of the important benefits of laser treatment:

• No need for drugs intake to lower intraocular pressure
• No hospitalization required
• No surgical risks
• A single day procedure, no need for long-term recovery 
• Treatment takes just a few minutes

Selective laser trabeculoplasty is the most common laser procedure for glaucoma treatment. It is performed for an open-angle form of the disease. With the help of a laser the doctor processes the trabecular diaphragm. He forms small holes in it, which allow for aqueous humor passing through them. Its outflow is normalized, which lowers the pressure in the eye.

It is a quick, safe and painless procedure. The patient receives a temporary result that lasts for several years. He must be constantly examined by an ophthalmologist. Sooner or later, the holes made by the doctor will overgrow, and the outflow of aqueous humor will be impaired again. However, this disadvantage of selective laser trabeculoplasty is compensated by the fact that it can be performed many times, with a similar result. The half of the patients need the second procedure in more than 5 years, while every third of them needs it in more than 10 years.

The laser treatment is not usually considered as an alternative to surgery. It is used instead of drug therapy. The advantage is that the patient does not require constant use of drops, and better control over the progression of the disease is achieved. Accordingly, after performing laser trabeculoplasty, the risk of optic nerve atrophy and irreversible visual impairment is reduced significantly. Nonetheless, the laser procedure still cannot replace surgery.

Argon laser trabeculoplasty is an old technique that has been used in ophthalmology for over 40 years. The laser inflicts burns, which lead to the displacement of the trabecula inward. The tissues between the scars are stretched, the lumen between the fibers of the trabecula widens, which improves the outflow of aqueous humor. The procedure is effective only on the eyes with pronounced pigmentation of the Schlemm's canal. It has a higher risk of complications. It can be performed only once, since repeated argon laser trabeculoplasty is not only ineffective, but can also worsen the course of glaucoma.

Laser iridectomy. It is used for angle-closure glaucoma at the initial stage, without significant organic lesions of the anterior chamber angle. The doctor uses a laser to create a hole in the iris, which eliminates the pupillary block. After this surgery, the risk of serious complications is very low.

Laser descemethogoniopuncture. The procedure involves the formation of microfistula in the Descemet membrane. This intervention complements non-penetrating deep sclerectomy.

Surgical treatment

There are many operations for glaucoma management. All of them can be divided into fistulizing and non-fistulizing (penetrating and non-penetrating).

Trabeculectomy. It is the most common fistulizing surgery. It creates new pathways for the outflow of intraocular fluid from the anterior chamber of the eye under the conjunctiva. The doctor creates a direct connection between them by removing a fragment of trabecular tissue. This operation is often complemented by a basal iridectomy – creation of an artificial hole in the area of the iris root.

The penetrating surgical procedures have the following drawbacks:

• At least 10% of patients have scar tissue after surgery, which will disrupt the circulation of aqueous humor again. The complication is common in young patients. It complicates the follow-up operations for glaucoma.
• Due to scarring changes, the filter pad sometimes crawls onto the cornea and causes discomfort.
• Possibility of overcompensation development: the excessive outflow of aqueous humor can lead to reduced pressure inside the eye.
• Increased risk of cataracts development.

Non-penetrating deep sclerectomy is one of the most popular antiglaucoma operations. The doctors do not violate the integrity of the trabecular apparatus. It is used as a filter – a membrane through which aqueous humor penetrates. Non-penetrating deep sclerectomy has the following advantages over fistulizing operations:

• Practically zero risk of excessive decrease in intraocular pressure
• Minimal trauma
• More favorable risk of choroidal detachment and intraocular hemorrhage
• Possibility to be combined with other operations on the same eye

Nonetheless, the surgical procedure also has disadvantages. With the non-penetrating deep sclerectomy, the risk of scarring the filter pads is the same as with the penetrating surgery. At the same time, the effectiveness of surgical intervention is lower: in some patients, it is impossible to avoid penetrating surgery.

Iridectomy. It is used for angle-closure glaucoma. The surgical procedure is aimed at eliminating the pupillary block by creating a new pathway for the outflow of aqueous humor from the posterior chamber of the eye to the anterior chamber. They equalize pressure, the angle of the anterior chamber of the eye opens (before that it was blocked by the iris root).

Cyclocryocoagulation. Several applications of liquid nitrogen are applied to the surface of the ciliary body. In these areas, the tissue atrophies. This results in the reduced production of aqueous humor. This effect develops several days after the procedure. If this effect is insufficient, cyclocryocoagulation will be repeated in 2-3 weeks or more.

Laser cyclocoagulation. It is a similar procedure for achieving a therapeutic effect. The only difference is that tissues are destroyed not by liquid nitrogen, but by a laser.

Benefits of treatment in Israel

Israel offers many good eye clinics that perform safe and effective glaucoma surgery. You can go to the Sheba Medical Center, the Rambam Health Care Campus or the University Hospital Hadassah.

Here are the main benefits of glaucoma treatment in Israel:

• High-precision diagnostics allows determining the types of glaucoma and choose the best treatment method – the most sparing and effective at the same time.
• State-of-the-art equipment in the medical centers in Israel allows for minimally traumatizing operations and laser procedures without complications.
• Israeli ophthalmologists are trained in the best clinics in Europe and the United States.
• Possibility of obtaining a stable result even in patients with the most severe pathologies who have already had surgery for glaucoma and have not achieved intraocular pressure stabilization.
• Israeli hospitals perform surgery to simultaneously cure glaucoma and cataracts.
• Use of the very latest neuroprotective therapy and stem cells can improve vision in case of optic nerve atrophy, which develops against the background of glaucoma.
• Low cost of medical procedures and operations. The hospitals in Israel offer lower prices than those in developed countries in Europe and North America.

In complex cases, Israeli ophthalmologists use implants. They implant tubes in the patient's eye through which aqueous humor flows out. The implants reduce the risk of recurrence – even if the structures of the eye are scarred, the results of the operation will be preserved.

The patients with corneal scars, active neovascularization or aphakia undergo surgery to implant Ahmed or Molteno drainage systems in the eye. They provide sustainable results even in cases when fistulizing surgery is not possible or trabeculectomy is highly likely to be ineffective.

Where to seek help from?

To undergo treatment in Israel, you can use the Booking Health service. We represent the leading clinics of this country, doctors, medical programs, and prices. You can compare the cost of treatment in different hospitals and book the program at the best price. The Booking Health employees will arrange your trip to one of the hospitals in Israel. We offer the following services and benefits:

• Selection of the eye clinic that specializes in the treatment for glaucoma and demonstrates excellent results

• Reduced waiting time for treatment in Israel – you will undergo surgery before irreversible damage to the optic nerve occurs under the influence of the elevated intraocular pressure occurs
• Reduced cost of treatment – the price is reduced due to avoiding additional coefficients for foreign patients
• Direct communication with the doctor of the selected eye clinic
• Preparation of a treatment program in Israel without the need to repeat previously performed diagnostic tests
• Buying and forwarding medicines
• Communication with the hospital after treatment in Israel
• Organization of additional diagnostics and treatment in Israel

The Booking Health specialists provide high-quality services. We will book a hotel and airline tickets for you, meet you at the airport and take you to the hospital by car.