Taking another look

Two weeks after a revolutionary eye surgery that restored his vision once marred by glaucoma, Ronnie Everly still can't lift heavy objects or rake leaves since the dust could carry bacteria and bring on an infection. But those are minor inconveniences compared with the prospect of losing his sight.

Everly, of Olmstead, Ill., is one of about 10 patients in the region who have received the new Ex-Press mini glaucoma shunt. Dr. Charles Cozean Jr. is the only area doctor -- and one of two in Missouri -- performing the procedure, which helps reduce eye pressure related to glaucoma.

Glaucoma is a genetic disease of the eye that eventually causes blindness. Pressure builds in the eye, which restricts the optic nerve and diminishes vision. People with glaucoma typically use a series of eyedrops, laser treatments or surgery to help prevent its progression.

Many glaucoma patients report vision problems like a need for stronger prescription glasses, a loss of peripheral vision or even seeing blank spots in their vision long before a diagnosis is made by an optometrist or ophthalmologist. Glaucoma is detected through a check of the pressure in the eye.

Glaucoma patients often don't realize they have the disease because at least half have a normal pressure reading and few other symptoms, Cozean said. But checking the anatomy of the optic nerve can be critical for patients at high risk of getting the disease: those over age 40, people with a family history of the illness or who have suffered an eye injury.

Cozean implanted two Ex-Press mini glaucoma shunts in patients Monday at St. Francis Medical Center. The surgical procedure took about 15 minutes for each patient.

Small, metal deviceThe shunt is a metal piece about the size of a pencil lead that is inserted into the top outer corner of the eye. Its purpose is to drain the fluid that builds around the eye in glaucoma patients. The shunt lets the fluid drain into a small reservoir so that it is eventually reabsorbed in the eye.

Traditional glaucoma surgery is often a last resort for patients, said Cozean, who specializes in cata-racts and glaucoma treatment.

"We're really hoping this will replace the 150-year-old procedure," he said.

Traditional surgery was always the last option to suggest "because there is so much of a downside," Cozean said. The traditional trabeculectomy surgery takes about an hour, is painful, and about one-fourth of the patients still suffer the same problems a year later. After one failed surgery, it's often too difficult to do another because of scar tissue, he said.

In contrast, the Ex-Press mini shunt procedure takes about 20 minutes or less to insert into the eye. Doctors make a small incision in the eye and insert the shunt, which helps alleviate the pressure on the optic nerve and prevents further eyesight deterioration.

The new procedure was approved by the Food and Drug Administration in March 2002. Cozean has been using the new method about a month but expects patients to be more apt to consider surgical treatment now because the new procedure is less painful.

ljohnston@semissourian.com

335-6611, extension 126