Mr Rahman is a Regional Expert in minimally invasive treatments for glaucoma (known commonly as "keyhole" surgery, or MIGS). The aim of treatment is either to reduce or completely remove the number of eyedrops a patient may need to take. He has performed more iStent procedures than any other surgeon in Scotland, and is one of the most experienced surgeons in this type of surgery in the United Kingdom.
iSTENT INJECT GENERATION 3
The iStent Inject is one of the smallest implantable medical devices that exists. It is often inserted at the end of cataract surgery, so patients who need cataract surgery to improve their vision but who also have glaucoma would benefit. It can also be inserted even if cataract surgery is not required.
Once implanted, the device helps restore the natural ability of the eye to lower pressure, reducing or completely eliminating the need for eye drops.
Mr Rahman uses the latest generation 3 iStent device which maximises the chance of a successful outcome. Please look at the educational videos below for more information.
~60% of the patients were on 3 medications or more at baseline
~40% of the patients had already had some sort of surgical intervention for glaucoma (including SLT)
Post op IOP at 5 years was 14.1mmHg
Over 80% of patients were below 15mmHg after 5 years (versus 1% at baseline)
Medication reduction was from 2.7 -> 0.8 over 5 years (and remained flat over 5 years)
Nearly half of the patients were medication free after 5 years
Cup:Disc ratio, retinal nerve fibre layer thickness, and visual fields were all stable over 5 years
The follow up of the 125 patients was very good (121 at 5 years)
Hydrus Microstent
The Hydrus Microstent is a miniscule (roughly the size of an eyelash) curved device that is inserted into the Schlemm’s canal. Upon insertion, the Hydrus Microstent has the ability to dilate the canal by four to five times its natural width. This counters the collapse of the Schlemm’s canal which is induced by elevated intraocular pressure. The device is designed to be implanted in patients undergoing glaucoma surgery in conjunction with cataract surgery, reducing the intraocular pressure in adults with mild to moderate primary open-angle glaucoma.
~66% of patients remained medication free at 5 years
~50% reduction in the need for more invasive glaucoma surgery compared with cataract surgery alone
OMNI Surgical System
The Omni® Surgical System is a truly unique approach to the treatment of glaucoma. This is an implant-free procedure, setting it apart from most other MIGS. Removing as many blockages caused by the specialised tissue as possible, the Omni® is designed to relieve the pressure buildup in the eye by enabling fluid to drain more easily. The Omni® enlarges the drainage canal before delivering a unique, and importantly safe, fluid called viscoelastic which clears the channel in the eye. With a reduced resistance to fluid leaving the eye, the pressure reduces on the optic nerve.The Omni® has the capability to reduce or even eliminate the need for drops, and can be carried out at the same time as cataract surgery. The treatment is for those with open-angle glaucoma, whether it be mild, moderate or severe.
~100% of eyes had at least a 20% reduction in eye pressure at 2 years
~57.7% of patients were medication free at 2 years
SELECTIVE LASER TRABECULOPLASTY
Selective Laser Trabeculoplasty is a type of non surgical treatment that uses a laser to gently heat up some of the structures in the eye. This helps lower the eye pressure, and a recent landmark clinical trial called the LIGHT STUDY has suggested that this is an effective treatment option in patients with glaucoma. Mr Rahman is amongst the most experienced surgeons in Scotland in this Glaucoma Laser Treatment, and is currently the only private surgeon providing this treatment in Glasgow.
