A better way becomes clear
Though there are topical medications and laser procedures to treat glaucoma, surgery is the ultimate option once meds stop working, says Dr. Prywes. The standard procedure is a trabeculectomy - a delicate, invasive surgery that commonly requires a skilled glaucoma specialist to perform. Once the procedure is done, the wound must be sutured closed and drugs administered to keep scar tissue from forming.
Other procedures involve placing a shunt, but that, too, is a tricky operation and can lead to other problems, like double vision. Surgical solutions to glaucoma, says Dr. Prywes, "involve a lot of skill, a lot of time and intensive post-operative care. Usually they are successful In 50 to 70 percent of patients."
By contrast, the procedure to place the Xen Gel Stent takes 10 minutes, requires no suturing or general anesthesia and is straightforward enough to be mastered by comprehensive ophthalmologists. Patients also avoid post-operative problems like a reaction to anesthesia.
Dr. Prywes is now, at long last, realizing his vision to perform the procedure to save vision. On a 2014 trip to the Dominican Republic to perform the procedure and train other physicians in its use, he was moved nearly to tears to witness his original idea treating glaucoma in the way he imagined: simply, cleanly and successfully. "We operated on people and, when we came back the next day, it was like they'd never had surgery," he says.
In the meantime, AqueSys, Inc., the company that manufactured the stent, was bought by pharma giant Allergan, Inc. They allowed his original patent, which had been active for 17 years, to expire. "That means I don't get any royalties," he laughs. "But luckily I haven't given up my day job. And I never did this to make money. I did it because I perceived we could do something better, and we have."