Cheyenne Eye Clinic Doctors are on the lookout for new treatments.

The Future is Bright for Patients with Glaucoma

by Dr. Miller, Glaucoma Specialist

There have been more advances regarding the treatment of glaucoma in the last 5 years than all of the 17 years I have been practicing at the Cheyenne Eye Clinic.  This is great news for glaucoma patients, offering more options to preserve eyesight.

One area of development has been with eye medications.  Two novel glaucoma eye drops, Rhopressa and Vyzulta, have become available just this year.  They are novel because they have a different mechanism of action than the previous options.

When a patient’s glaucoma cannot be stabilized with drops or laser treatment, surgical options are considered.  Like the drops, there have been many advancements in minimally invasive glaucoma surgery (MIGS) procedures.  New procedures include the iStent Trabecular Micro-Bypass Stent, Hydrus Microstent, Trabectome, Kahook Dual Blade, CyPass, XEN Gel Stent, Ab Interno Canaloplasty and the Micropulse laser, to name a few. These procedures have the benefit of being less invasive than traditional glaucoma surgery, and therefore have a lower risk profile; however, the most significant eye pressure lowering is still had with traditional glaucoma surgery.

Physicians, like myself, continually learn and train to determine what procedures work best for our patients.


The Future is Here for Corneal Surgical Procedures and Dry Eye Treatments  

The practice of cornea surgery has evolved significantly in the last few decades and patients have been benefiting from these advancements with better vision, faster. The first corneal transplant was in 1905. The procedure had not changed much since that time until 1988, when the first partial thickness corneal transplant was performed.  Both DSEK (Descemet’s stripping endothelial keratoplasty) and DMEK (Descemet’s membrane endothelial keratoplasty) are partial thickness corneal transplants that can offer faster visual recovery for patients who qualify for these types of grafts.

An artificial cornea (Boston Keratoprosthesis) has been helping patients with multiple failed corneal transplants, and a new FDA approved treatment called corneal cross-linking can help patients with keratoconus (progressive corneal thinning disease) achieve stability of their cornea by strengthening the collagen there.

In regards to new medications, Xiidra was recently FDA approved as the first dry eye treatment targeted to help with both the signs and symptoms of dry eye. There is also a new medical device to treat dry eyes called TrueTear. It works by stimulating the nerves in the nose that help produce tears.

Because of the wide range of treatment options for corneal diseases, each of our patients receives customized care catered to their specific vision needs.


The Future is in New Research and New Hope for Retina Patients

by Dr. Piwonka, Retina Specialist

Over the last few months, there has been a lot of buzz regarding gene therapy and stem cell research in the specialty of retina; CBS’ 60 Minutes television program recently aired a segment addressing the issue. Gene therapy and stem cell research have the potential to treat each and every type of inherited retinal degeneration and age-related macular degeneration (AMD). To help clarify these issues, I have listed current aspects of gene and stem cell research for retina.

Regarding stem cell therapy, researchers have developed new models of retinal degeneration that enable transplantation of retinal sheets derived from human stem cells. Stem cells are a specific type of cell that can grow and potentially differentiate into any cell type in the body. The thought being that if vision is lost due to permanent cell loss/degradation (as seen in dry/non-exudative age-related macular degeneration {AMD}), these lost cells can be regrown with stem cells and restore previously lost vision. With that in mind, recently reported preliminary laboratory study results show that transplanting retinal tissue derived from embryonic or induced pluripotent stem cells is a promising approach for the treatment of retinal degeneration. The researchers have reported that surgically transplanted retinal sheets in the laboratory setting have: shown success in tolerating the surgical integration process, shown viability in maturing to known retinal structures and have shown signs of becoming responsive to light. These are very preliminary findings but they show great promise in a field that has been previously devoid of options to restore vision.

Gene therapy involves the introduction of genetic material into a cell. The components of gene therapy include the genetic material and the delivery vehicle. Though the process sounds simple, it is very complex. Specific genes are targeted with this therapy and delivered underneath the retina after a surgical procedure called a vitrectomy. A vitrectomy is an eye surgery where the inside eye fluid is replaced. The targeted genes are directed into the cells that line the back of the eye by viral vectors. These viral vectors are the same ones used by a virus to get into our body and give us the common cold and flu. With the FDA approval in early 2018 of Luxturna (Spark Therapeutics), gene therapy in retina officially entered the realm of clinical reality. Luxturna is designed to treat a rare form of an inherited retinal disease known as Leber’s Congenital Amaurosis. Other diseases that are being studied from treatment with gene therapy include wet age-related macular degeneration, certain types of retinitis pigmentosa, Leber hereditary optic neuropathy, choroideremia, Stargardt’s disease, Best’s disease, X-linked retinoschisis, and achromatopsia.


At Cheyenne Eye Clinic and Surgery Center, our patients are our priority. We’re focused on you, and we’ll continue to stay in front of medical advancements regarding your eye health.


Our Optical Department will close at 2:00 PM on November 20th to attend the memorial service for a dear friend and colleague. 

We apologize for the inconvenience.