Glaucoma Surgery
Do You Need It?

Several Different types of surgery are used including laser surgery and more conventional procedures.

Laser Surgery:

In the last couple of decades, a procedure called trabeculoplasty (Truh-BEK-you-loe-pla-tee) has been used increasingly in the treatment of open angel glaucoma.

The doctor uses a high-energy laser beam to shrink part of the trabecular meshwork.

This helps aqueous humor drain more easily from the eye.

This type of laser surgery is an office procedure that takes 10 to 20 minutes.

You’ll be given an anesthetic eye drop, seated at a slit lamp and fitted with a special lens on your eye.

The doctor aims the laser through the lens at the trabecular meshwork and applies burns to it.

You will see bright flashes of light.

After the surgery you can immediately resume normal activities without discomfort.

The doctor will check your eye pressure 1 to 2 hours after the procedure and several times in the following weeks.

He or she may prescribe anti-inflammatory eye drops for you to use for a few days following trabeculoplasty.

It may take a few weeks before the full effect of the surgery becomes apparent.

In almost all cases, laser surgery for glaucoma initially lowers intraocular pressure.

However, its effects may wear off over time.

Studies show that eye pressure rises in many people 2 to 5 years after they receive the laser treatment.

Conventional Surgery:

If eye drops and laser surgery aren’t effective in controlling your eye pressure, you may need an operation called a trabeculectomy (truh-bek-yoo-LEK-tuh-mee).

This procedure is done in a hospital or an outpatient surgery center.

You’ll receive medication to help you relax and eye drops and an injection of anesthetic to numb your eye.

Using delicate instruments under an operation microscope, the surgeon creates an opening in the sclera and removes a small piece of the trabecular meshwork.

The aqueous humor can now freely leave the eye through this hole.

As a result your eye pressure will be lowered.

The conjunctiva covers the hole, so there’s not an open hole in your eye.

Your doctor will check your eye in several follow-up visits.

You will use antibiotic and anti-inflammatory eye drops for some time after the operation to fight infection and scarring of the newly created drainage opening.

Scarring is a particular problem for young adults, blacks and people who have had cataract surgery.

This procedure works best if you haven’t had any previous eye surgery.

Although glaucoma surgery may preserve current vision, it can’t restore already lost vision.

Sometimes a single surgical procedure may not lower eye pressure enough, in which case you’ll need to continue using glaucoma drops or have another trabeculectomy operation.

Drainage Implants:Another type of operation, called drainage implant surgery, may be performed on people with secondary glaucoma or children with glaucoma.

Like the trabeculectomy, drainage implant surgery is performed at a hospital or an outpatient clinic.

You’ll be given medication to help you relax and eye drops and anesthetic to numb the eye.

Then the doctor inserts a small silicone tube in your eye to help drain aqueous humor.

After the surgery you’ll wear an eye patch for 24 hours and use eye drops for several weeks to fight infection and scarring.

Your doctor will check your eyes several times in the weeks that follow.

Complication from glaucoma surgery may include infection, bleeding, eye pressure that remains to high or to low and, potentially, loss of vision.

Having eye surgery may also speed up the development of cataracts.

Most of the complications can be effectively treated.

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