Doctors Marc Lieberman, George Tanaka, and Patricia Wong specialize in the diagnosis and treatment of glaucoma. Supported by a wonderful staff, they offer comprehensive glaucoma expertise for patients and referring physicians throughout the Bay Area.
Diagnosis, medical treatment, laser treatment including MicroPulse P3 CYCLO G6 laser, YAG laser, argon laser, SLT; microsurgical treatment of glaucoma including trabeculectomy, bleb revision, bleb needling, Express Shunt, ab externo canaloplasty, ab interno canaloplasty (ABiC), GATT, Kahook Dual Blade, iStent trabecular bypass, Cypass Micro-Stent, XEN gel stent, aqueous shunt placement (Ahmed, Baerveldt, Molteno 3) as well as small incision cataract surgery.
Operating as usual
[08/18/20] After a one year sabbatical, Dr. George Tanaka will be returning to work at our San Francisco and Oakland offices starting in September 2020. Dr. Tanaka is looking forward to re-connecting with his patients and referring doctors in spite of the ongoing pandemic. He hopes everyone is staying safe and healthy!
firstrepublic.com Access to proper healthcare continues to be a concern for man, but Pacific Vision Foundation works to care for those who are often shut out of the system.
Glaucoma Specialists's cover photo
Article I wrote for Review of Ophthalmology based on a talk I gave at this year’s AGS meeting in NYC. Bottom line: not everyone with a narrow angle needs a hole put in their iris. At least not until we have better clinical evidence that this is necessary in every case. (page 44)
Feeling grateful for being part of something bigger
Drs. Tanaka and Lieberman were recognized as research mentors and discussants for the CPMC residents at Barkan Day.
Video describing the mission of Pacific Vision Foundation.
Video from Dr. Tanaka's recent mission trip to Guatemala
I recently had the chance to film in Nuevo Progreso, Guatemala for a week with some pretty great people. It was an experience that changed me in more ways th...
A relatively straightforward case from this week: trimming a tube that is too long in the anterior chamber. A tube that is too long can lead to corneal endothelial cell loss and corneal decompensation. After making two corneal incisions and reforming the anterior chamber with viscoelastic, the end of the tube is grasped with MST forceps while an MST intraocular scissors is used to trim the tube. The cut portion of the tube is removed, and the viscoelastic is irrigated from the eye. The corneal incisions are self sealing.
Glaucoma Specialists's cover photo
Pics from our annual Glaucoma Specialists Holiday Party!
This video demonstrates an impressive nearly 180 degree fluid wave through the nasal collector channels immediately after implanting a single iStent through the nasal trabecular meshwork in conjunction with cataract surgery. A fluid wave is seen as a blanching of the peri-limbal conjunctival vessels as blood inside the vessels is replaced by clear balanced self solution flowing through the lumen of the iStent and filling Schlemms canal. Observation of a fluid wave provides direct evidence that the distal outflow system is patent and functional, indicating that a drop in intraocular pressure is likely in the next several weeks following iStent implantation. A beautiful and striking demonstration of aqueous physiology!
From last year's Congress of the Colombian Society of
El Dr. George Tanaka, invitado internacional del ###VII Congreso Nacional e Internacional de Oftalmología, nos cuenta un poco sobre su presentación en el con...
This was probably the longest surgical case of my career a few weeks ago (3 hours):
A 23 year-old woman with a history of congenital glaucoma had undergone multiple surgeries in her right eye: trabeculotomy, trabeculectomy, Ahmed valve placement, and Ahmed valve revision. She lost her left eye after multiple surgeries for retinal detachment. She was noted to have thin conjunctiva over her tube, borderline IOPs on maximal medical therapy, and advanced visual field loss from glaucoma. She developed irritation in her only seeing right eye and was referred to our practice with a tube erosion and IOP of 43. Gonioscopy revealed the tube had retracted from the anterior chamber. A 4 mm tube erosion was present just posterior to the supero-temporal limbus. Paracentesis was performed to bring the IOP down to 14. Oral Diamox was started.
What would you do to save the vision in this patient's only seeing eye?
A tube exchange procedure was performed. Initial inspection confirmed both tube retraction and tube erosion. (Photo 1) A conjunctival incision was made anterior to the Ahmed plate, the capsule was incised with disposable handheld cautery, and the plate was dissected free and removed. (Photo 2) Further inspection revealed the tube had also eroded INTO the eye exposing uveal tissue. (Photo 3) A scleral patch graft was used to cover this defect. A 250 sq mm Baerveldt glaucoma drainage device was placed into the supra-Tenons space over the capsule of the original Ahmed. The tube was routed into the anterior chamber at 12 o'clock to avoid areas of scleral thinning. (Photo 4) The tube was covered with a scleral patch graft. (Photo 5) The conjunctival was closed. (Photo 6) Additional scleral tissue was placed to reinforce the area of tube erosion. (Photo 7) The conjunctiva could not be closed over the scleral patch grafts. These exposed areas were covered with amniotic membrane using tissue glue to facilitate re-epithelialization. (Photo 8) At the conclusion of the case the tube was in good position. There were no areas of uveal or scleral exposure.
The next day visual acuity was count fingers and IOP was 12. At her one week post-operative visit the patient could read text messages on her cell phone and the IOP was 10.
Fingers crossed for a good outcome! More to follow!
We finally got our offical "Suite 330" numbers on the door of our beautiful glass wall!!!
Another great mission trip to Hospital de la Familia. Our team of eye surgeons performed 93 surgeries in six days. Really impressed by the cohesiveness and camaraderie of our entire team and by the gratitude of the patients we treated.
It was a privilege and honor to lecture and perform live surgery at the 8th Annual Central American and Caribbean Glaucoma Congress! I was truly touched by the generosity and hospitality of my Panamanian colleagues who worked so hard to put this meeting together. I had the opportunity to perform the first ab interno canaloplasty (ABiC) in Central America and be a part of the first meeting where all five MIGS procedures were performed live in one setting. Looking forward to returning to this region again in the future! Viva la Panama! 🇵🇦😷👁
Fun times and great clinical pearls at this year's American Glaucoma Society Annual Meeting in Coronado, California.
"Out with the old, in with the new"
Removing a failed infra-Tenons Baerveldt 350 sq mm glaucoma drainage device (GDD) and replacing it with a supra-Tenons Baerveldt 250 sq mm GDD. For the gory details see the YouTube link:
Preliminary results show equivalent efficacy to placing a second GDD in another quadrant = saving conjunctival "real estate"
Video demonstrating a fluid wave after implanting an iStent trabecular bypass device. Irrigating the iStent with balanced salt solution causes blanching of the aqueous veins and collector channels, thereby confirming the patency of those drainage pathways and indicated the device is likely to be effective in lowering intraocular pressure.
Very significant paper just out by my co-resident, Andy Sorenson.
THIS IS HUGE!
finance.yahoo.com DUBLIN, Nov. 22, 2016 /PRNewswire/ -- Allergan plc (NYSE: AGN) announced today the U.S. Food and Drug Administration (FDA) has cleared the XEN® Glaucoma Treatment System (consisting of the XEN45 Gel Stent and the XEN Injector) for use in the U.S. The XEN Glaucoma Treatment System reduces intraocular
We're officially into our new office now!
We've been waiting for the EAGLE results for some time! I suspected these would be the results. I don't think clear lens removal is overly aggressive if supported by clinical data in this subset of patients. I commend the authors for their important work!
medscape.com For primary angle-closure glaucoma, clear-lens extraction was more effective and cost-effective than laser peripheral iridotomy, and should be considered for first-line therapy.
Glaucoma doc selfie :)
Thanks for the shout out from one of my patients Khrispy K!
youtube.com Remixing my orthodontist’s voice, buying new shoes for my mom, making fun of my brother, and hanging out with friends is the life. Fog by jimmysquare https:/...
I'm honored to be featured as one of the contributors in this month's Consultation Section of the Journal of Cataract and Refractive Surgery!
Almost done with the Big Move (whew!)....
The Big Move is happening now.....
TWO WEEKS until we move into our brand new clinic!!!
The walls are painted, counters and exam desks are installed, carpet is being put down!! Moving in first week of August (we hope)
The walls are up in our new clinic!!! Coming soon to an Eye Institute near you in July 2016.
Speaking with Joshua Young, MD, at the ASCRS meeting in New Orleans about alternatives to tube shunt patch grafts. www.ewreplay.org
A novel technique for repairing a bleb leak -- a complication of glaucoma surgery (trabeculectomy) which can lead to a vision-threatening infection if not treated.
This video describes a novel method for internal repair of an avascular bleb using a small autologous Tenons graft. This method is ideal for focal leaks loca...
Diagnosis, medical treatment, laser treatment including MicroPulse P3 CYCLO G6 laser, YAG laser iridotomy, YAG laser capsulotomy, argon laser, selective laser trabeculoplasty (SLT); microsurgical treatment of glaucoma including trabeculectomy, bleb revision, bleb needling, Express Shunt, XEN gel stent, ab interno canaloplasty (ABiC), gonioscopy-assisted transluminal trabeculotomy GATT, OMNI Surgical System, Kahook Dual Blade, iStent Inject trabecular bypass, aqueous shunt placement (Ahmed, Baerveldt, Molteno 3) as well as small incision cataract surgery, toric, presbyopic-correcting intraocular lens implants.
|Monday||08:30 - 17:00|
|Tuesday||08:30 - 17:00|
|Wednesday||08:30 - 17:00|
|Thursday||08:30 - 17:00|
|Friday||08:00 - 16:00|
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