Dr. Laurence Kaye is one of Tucson’s Glaucoma Specialists, having received fellowship training at Mount Sinai Hospital (Cleveland, Ohio) and an additional preceptorship at Ophthalmic Consultants of Boston.
As a result of his training and experience, many community ophthalmologists, optometrists, and internists refer their more challenging cases to Tucson Eye Care for evaluation and management.
Glaucoma is a disease of the optic nerve and is characterized by a change in the appearance of the nerve with a corresponding loss of peripheral vision. While there are many risk factors associated with the disease, the most common is an elevation of eye pressure. In most cases, our treatment is aimed at lowering eye pressure to a safe range to prevent progression of glaucoma. The ideal pressure for each eye varies and is determined by following the course or progression of the disease with several examinations over time.
In addition to a thorough clinical examination, we provide the full spectrum of glaucoma diagnostic testing. These include:
- Ultrasonic pachymetry – corneal thickness measurements
- Stereo optic nerve head photography
- Heidelberg retinal tomography – 3D optic nerve head imaging
- Humphrey visual field testing- the advanced software allows the test to be done in a few minutes per eye in most cases
- OCT – ocular coherence tomography –nerve fiber layer analysis
- ORA –ocular response analyzer – assesses the impact of corneal thickness and elasticity on the accuracy of pressure measurements
If the need for treatment is established, our first option is to use glaucoma drops. Up to four classes of glaucoma drops are currently favored in our practice. The choice of the ideal regimen is personalized for each patient and each eye based on the effectiveness of the drug, the frequency of administration, and the safety profile.
SLT – Selective Laser Trabeculoplasty
The SLT laser represents the newest, safest way to improve pressure control. It is effective in 80% of patients and often decreases or eliminates the need for medications or delays the need for surgery. As an in-office procedure, it is very safe, with the major risk being a transient elevation in eye pressure in rare cases.
The results of our glaucoma surgery (trabeculectomy) reveal that we are able to control eye pressure in 85% of our patients with one operation. While the results are good, we are constantly evaluating other options and methods to treat glaucoma as they become available to us.
Dr. Kaye has pioneered a technique where glaucoma surgery is performed without a numbing injection behind the eye. This painless procedure is done with numbing drops and a small injection on the surface of the eye. This innovation adds a measure of safety to the procedure and has yielded an 85% success rate. We have presented the results of our procedure at an International Ophthalmic meeting in May 2000.
In the rare situation where trabeculectomy surgery is not effective or indicated, Seton surgery with a Baer Veldt glaucoma valve or cycloablation with a DIODE laser are other options we will consider