Bearie Eyes Glaucoma Relief

May 6, 2002
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GRAND RAPIDS — Here’s one of those medical stories that just makes us laymen cringe and wince when we hear it.

Imagine a surgeon placing a very fine scalpel at a shallow angle against the white of your eye, then slicing and bending back a very thin, 5-by-5 millimeter flap of that surface.

Once he does that, he shaves back a second 4-by-4 flap from beneath the first — and then, after that, removes a 1-by-4 millimeter piece of tissue.

At that point — immediately adjoining the thin network of circulatory vessels that line the eye’s interior — he gently nudges a tiny collagen cylinder into place, and then closes up the whole business with a single miniscule stitch.

The surgery, done entirely with a microscope, is termed a non-penetrating deep sclerectomy. It is a surgical corrective procedure for glaucoma originally pioneered by a Russian eye surgeon, since brought to the United States and approved by the FDA.

And as unpleasant as the surgery may sound to a layman, the man who employs the technique — Brian D. Bearie, D.O. — says that most patients have no difficulty driving home on their own after the 15- to 30-minute procedure.

Glaucoma is a disease in which a slow build-up of pressure within the eye can cause sight to deteriorate and then be lost permanently. And at the moment, Bearie — founder and medical director of the Grand Rapids Eye Institute and Laser Center — is the only surgeon in Michigan certified to perform the operation.

Bearie explains that the wick he implants — as suggested by its brand name, AquaFlow — serves as a drain to relieve ocular pressure. He explained that in a healthy eye, the fluid build-up is handled by microscopic natural drains.

“But in glaucoma, they become blocked,” he said. “Nobody knows why. Then, as pressure builds, it acts upon the eye’s softest tissue — the retina and the optic nerve. People often lose a lot of their sight before they even become aware of it. And if it goes untreated, then they lose their sight permanently.”

He said that glaucoma is relatively easy to arrest and prevent, but the insidious thing about the disease is that most people who suffer from it don’t realize they have it.

Bearie said the collagen wick pulls excess fluid from the eye. He said that over time the body absorbs the wick, leaving behind a tiny open drain that serves the same function.

What Bearie likes about the procedure is that it is not invasive, as are more traditional forms of surgery to relieve eye pressure. The older form of surgery, which penetrates into the eye, has side effects that can last for days or weeks and presents a more inviting avenue for infection.

He performs the traditional surgery as well as the AquaFlow innovation.

He learned the procedure during what he considers his biggest career break: a year-long fellowship at the Colorado Eye Institute in Denver. It’s a form of surgery that takes place on his particular “turf,” the front half of the eye.

“I’m not saying this procedure is a panacea for glaucoma,” he told the Business Journal, “but it is a marked improvement over invasive surgery to relieve the pressure. Patients experience less soreness and redness of the eye and their vision is much clearer.

“Their follow-up visits are also reduced, as is the amount of medication they are required to use post-operatively.”

Bearie also is one of a group of surgeons who has done research for the FDA in implantations for the condition called presbyopia, the near-sightedness that afflicts nearly all humans with the onset of middle age.

He estimates it will be a decade before that surgery is approved for general use.

Bearie has been in practice here since 1994, when he took over the practice of Bill Zimmerman.

“I’m like Bill,” he said. “He was very progressive. He did the first corneal transplants in West Michigan.”

Something new Bearie faces that didn’t afflict his predecessor so sorely was the paper highway — as opposed to the paper trail — that has become integral to modern American medicine of almost any sort.

Bearie sees 80 to 100 patients a day — a tremendous flow of work which necessitates a large staff to handle the paper flow for him, as well as for the clinic’s optometrist (running 40 patients a day) and a new ophthalmologist and associate, Howard Adelson, DO.

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