Glaucoma Surgery

Once a diagnosis of glaucoma has been made, treatment depends on the form of the disease and its severity. Intraocular pressure is often reduced using eye drops or intravenous methods. In addition, laser surgery may be required to open the eye’s drainage system to allow fluid to drain. If these treatments do not work traditional surgery may be necessary.

Laser trabeculoplasty

Laser trabeculoplasty helps fluid drain out of the eye. Your doctor may suggest this step at any time. In many cases, you will need to keep taking glaucoma medicines after this procedure. Before the surgery, numbing drops are applied to your eye. As you sit facing the laser machine, your doctor holds a special lens to your eye. A high-intensity beam of light is aimed through the lens and reflected onto the meshwork inside your eye. You may see flashes of bright green or red light. The laser makes several evenly spaced burns that stretch the drainage holes in the meshwork. This allows the fluid to drain better.

Conventional surgery

Conventional surgery makes a new opening for the fluid to leave the eye. Your doctor may suggest this treatment at any time. Conventional surgery often is done after medicines and laser surgery have failed to control pressure. Conventional surgery, called trabeculectomy, is performed in an operating room. Before the surgery,
you are given medicine to help you relax. Your doctor makes small injections around the eye to numb it. A small piece of tissue is removed to create a new channel for the fluid to drain from the eye. This fluid will drain between the eye tissue layers and create a blister-like “filtration bleb.”

For several weeks after the surgery, you must put drops in the eye to fight infection and inflammation. These drops will be different from those you may have been using before surgery. Conventional surgery is performed on one eye at a time. Usually the operations are four to six weeks apart.

Conventional surgery is about 60 to 80 percent effective at lowering eye pressure. If the new drainage opening narrows, a second operation may be needed. Conventional surgery works best if you have not had previous eye surgery, such as a cataract operation.

Sometimes after conventional surgery, your vision may not be as good as it was before conventional surgery. Conventional surgery can cause side effects, including cataract, problems with the cornea, inflammation, infection inside the eye, or low eye pressure problems. If you have any of these problems, tell your doctor so a treatment plan can be developed.

Canaloplasty

To perform Canaloplasty, your doctor will create a tiny incision to gain access to a canal in the eye. A microcatheter will circumnavigate the canal around your iris,  enlarging the main drainage channel and its smaller collector channels through the injection of a sterile, gel-like material called viscoelastic. The catheter is then  removed and a suture is placed within the canal and tightened. This tightened suture ensures that the canal remains open. By opening the canal, the pressure inside
your eye will be relieved.