By Mary Malloy
Berke, an ophthalmologist, specializes in glaucoma treatment and cataract surgery. He is a founding partner of OCLI, which has offices in Rockville Centre, Lynbrook, Valley Stream, East Meadow, Stony Brook and Manhasset. His two-year study results showed that combining the two procedures can dramatically decrease the postoperative need for glaucoma medication.
Cataracts are a vision problem caused by a clouding of the lens of the eye. It is most common in people over 50 years of age. This clouding can distort or even block light rays before they reach the retina. Left untreated, cataracts can impair vision and lead to blindness. Glaucoma is a condition affecting the optic nerve, usually seen with increased pressure within the eye. This too can lead to blindness, especially in the elderly.
ECP, a laser procedure used to treat glaucoma, has fast become popular in the U.S. Cataract surgery is the most often performed surgery in the nation, and Berke has found that combining the two procedures can save patients hundreds of dollars a month in glaucoma medication by reducing the number of medications needed after surgery.
The study, "ECP in the Management of Cataract and Medically controlled Glaucoma," which Berke co-wrote with four colleagues, was presented at the American Glaucoma Society's annual meeting in Charleston, S.C., last month. The study, which followed more than 700 patients for an average of 2 1/2 years, was the largest ever done on this type of surgery.
A technique known as phacoemulsification has become the preferred method of cataract removal. A very small incision is made at the top of the eye, and high-frequency waves sent through the surgical instrument break the cataract up into minute fragments, which are then removed. "This ultrasound vibrates about 40,000 times per second," Berke explained. A plastic foldable lens is inserted into the opening, and once inside, it unfolds, held on by "springs." This lens takes the place of the one that has been removed, and allows the patient to focus. Stitches are not needed because of the very small incision, and it heals quickly.
ECP is a computer-assisted laser procedure used to surgically treat glaucoma. The laser "zaps" and shrinks the amount of fluid, according to Berke. His study showed that cataract surgery combined with ECP was effective in decreasing the long-term need for glaucoma medications and did not increase the risk of serious complications.
Berke began performing the two surgeries together in 1999. Noting that 15 percent of cataract patients also suffer from glaucoma, he surmised that ECP could easily be used during their cataract surgery, because it uses the same incision. Statistically, there was a 60 percent decrease in the average number of medications used after the procedure.
Berke does his surgery at the Island Eye Surgicenter in Carle Place. The center, which opened in 2000, specializes in the surgical care and treatment of eye disorders.
"The follow-up data shows convincing evidence that ECP, combined with cataract surgery, is a very safe procedure, associated with very few serious complications," Berke said.
For more information, contact the OCLI at (866) SEE-OCLI.
Comments about this story? Mmalloy@liherald.com or (516) 569-4000 ext. 202.
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Cataract and glaucoma Q&A
Q. What is a cataract?
A. A cataract is a cloudy area in the lens of the eye. About 50 percent of Americans ages 65 to 74 have at least one cataract. When the eye's lens becomes cloudy, light can't be properly focused on the retina, so visual acuity decreases.
Q. What are the symptoms?
A. Some symptoms may include cloudy, fuzzy or foggy vision; trouble doing close work; colors that seem dull or faded; frequent changes in vision prescription; halos around lights; and a milky white or cloudy spot in the center of the eye.
Q. How do you get cataracts?
A. The normal process of aging causes the eyes' lenses to harden and become cloudy, or opaque. In younger people, cataracts can result from an injury, certain drugs, long-standing inflammation or illnesses such as diabetes. Babies can be born with a condition known as congenital cataract.
Q. What is glaucoma?
A. Glaucoma is elevated pressure in the eye. The eye is constantly producing and draining a fluid called aqueous humor. In a glaucomatous eye, this fluid doesn't drain properly, resulting in an increase in the pressure inside the eye. This gradually destroys vision, and if left untreated will eventually lead to blindness by destroying the optic nerve. With early diagnosis and treatment, vision may be preserved. There are four different types of glaucoma: chronic, acute, congenital and secondary.
Q. What can increase my risk of developing glaucoma?
A. Age (at least 45 years old without regular eye examinations); family history of glaucoma; African American or Asian descent; diabetes; nearsightedness; steroid use; past eye injury.
Q. How can I tell if I have glaucoma? Because the disease is nicknamed the "silent thief," the best way to check for it is during a routine eye examination. The test is essentially pain-free and takes only seconds.
Source: Island Eye Surgicenter's Web site (www.islandeye.net)
