Glaucoma Surgery


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	Learn about Laser and Conventional Surgery for the Treatment of Glaucoma

Laser surgery
(also called laser trabeculoplasty): Laser surgery helps fluid drain out of the eye. Although your eye care professional may suggest laser surgery at any time, it is often done after trying treatment with medicines. In many cases, you will need to keep taking glaucoma drugs even after laser surgery.

Laser surgery is performed in a doctor's office or eye clinic. Before the surgery, your doctor will apply drops to numb the eye.

As you sit facing the laser machine, your surgeon will hold a special lens to your eye. A high-energy beam of light is aimed at the lens and reflected onto the meshwork inside your eye. You may see flashes of bright green or red light. The laser makes 50-100 evenly spaced burns. These burns stretch the drainage holes in the meshwork. This helps to open the holes and lets fluid drain better through them.

Your surgeon will check your eye pressure shortly afterward. He or she may also give you some drops to take home for any soreness or swelling inside the eye. You will need to make several follow-up visits to have your pressure monitored.

Once you have had laser surgery, over the entire meshwork, further laser treatment may not help. Studies show that laser surgery is very good at getting the pressure down. But its effects sometimes wear off over time. Two years after laser surgery, the pressure increases again in more than half of all patients.

Iridectomy

Iridotomy

Conventional surgery: The purpose of surgery is to make a new opening for the fluid to leave the eye. Although your eye care professional may suggest it at any time, this surgery is often done after medicine and laser surgery have failed to control your pressure.

Surgery is performed in a clinic or hospital. Before the surgery, your surgeon gives you medicine to help you relax and then small injections around the eye to make it numb.

Glaucoma Treatment

The surgeon removes a small piece of tissue from the white (sclera) of the eye. This creates a new channel for fluid to drain from the eye. But surgery does not leave an open hole in the eye. The white of the eye is covered by a thin, clear tissue called the conjunctiva. The fluid flows through the new opening, under the conjunctiva, and drains from the eye.

You must put drops in the eye for several weeks after the operation to fight infection and swelling. (The drops will be different than the eyedrops you were using before surgery.) You will also need to make frequent visits to your doctor. This is very important, especially in the first few weeks after surgery.

Glaucoma Treatment Showing Route of Fluid

In some patients, surgery is about 80 to 90 percent effective at lowering pressure. However, if the new drainage opening closes, a second operation may be needed. Conventional surgery works best if you have not had previous eye surgery, such as a cataract operation.

Keep in mind that while glaucoma surgery may save remaining vision, it does not improve sight. In fact, your vision may not be as good as it was before surgery.

Like any operation, glaucoma surgery can cause side effects. These include cataract, problems with the cornea, inflammation or infection inside the eye, and swelling of blood vessels behind the eye. However, if you do have any of these problems, effective treatments are available.