Glaucoma Surgery

How Common is This Procedure?

Glaucoma affects millions globally, and surgery is an option for those whose condition does not respond well to medications. Although many people with glaucoma can manage their condition without surgery, some cases require surgical intervention to protect eye health and vision.

Types of Glaucoma Surgeries

Glaucoma surgeries are divided into laser and incisional surgeries, which vary based on the procedure’s location and purpose. Laser surgeries are typically performed in the clinic, while incisional surgeries occur in an operating room. Your eye specialist will discuss the best surgical approach for your specific condition.

Types of Laser Surgeries

1. Laser Trabeculoplasty: This is the most common laser surgery for open-angle glaucoma, a short, in-office procedure. There are two versions:

   • Argon Laser Trabeculoplasty (ALT): This traditional method has largely been replaced by SLT.
   • Selective Laser Trabeculoplasty (SLT): A newer, more targeted approach that is also repeatable if needed.

   SLT is recommended as a first-line treatment for open-angle glaucoma, helping control eye pressure for many people.

2. Laser Peripheral Iridotomy (LPI): Used for closed-angle glaucoma, LPI creates a tiny hole in the iris, allowing fluid to flow freely. It may be a preventive measure for individuals with narrow angles.

3. Cyclophotocoagulation (CPC): This laser treatment reduces fluid production in the eye. It is often recommended for those with both glaucoma and low vision.

   • Transscleral CPC: The laser is applied externally to treat the ciliary body, which produces fluid.
   • Endoscopic CPC: This is performed during cataract surgery or if cataract surgery has already been completed.

Incisional Surgeries

1. Trabeculectomy: A common incisional surgery where an opening is made in the white part of the eye (sclera) to create a new drainage pathway, bypassing the eye’s natural drainage system to reduce pressure.

2. Tube Shunt: A small tube is inserted into the eye’s drainage area, helping to divert fluid and lower pressure. Shunts are often recommended based on the severity of the glaucoma.

3. Minimally Invasive Glaucoma Surgery (MIGS): Newer technologies, such as MIGS, involve smaller incisions and shorter recovery times. MIGS may be an option for those with mild to moderate glaucoma and is often performed alongside cataract surgery.

Preparing for Glaucoma Surgery

Before surgery, your specialist at Visualis Eye Clinic will guide you through the preparation process. This may include:

• A comprehensive eye examination and diagnostic tests.
• A discussion of your expectations and goals for surgery.
• A review of your medical history and medications.

You may be asked to avoid certain medications, arrange for transportation, and fast for a specified time before surgery if general anesthesia is planned.

What Happens During Glaucoma Surgery?

The procedure varies by type. Laser surgeries are quick, in-office procedures, while more complex surgeries like trabeculectomies and tube shunts are performed in an operating room with local or general anesthesia. Most glaucoma surgeries are outpatient procedures, so you can return home the same day.

Recovery After Glaucoma Surgery

Recovery time depends on the type of surgery. Laser surgeries may allow you to resume activities the next day, while incisional surgeries like trabeculectomy require a longer recovery period, possibly up to a month. You’ll likely need:

• Eye drops to prevent infection and control inflammation.
• Regular follow-up appointments to monitor eye pressure and healing.
• A protective bandage over your eye, with instructions to keep it dry and avoid rubbing.

When to Contact Your Eye Specialist

After surgery, your provider will schedule follow-ups to monitor your progress. However, you should reach out to Visualis Eye Clinic if you experience any of the following:

• Severe pain or discomfort.
• Vision changes or sudden vision loss.
• Persistent redness, discharge, or swelling.

A Message from Visualis Eye Clinic

At Visualis Eye Clinic, we are dedicated to providing the best glaucoma care to protect your vision and quality of life. Contact us if you have any questions or to learn more about which glaucoma treatment is right for you.