Surgery for Glaucoma

What is glaucoma?

Glaucoma is an eye disease in which the nerve that connects the eye to the brain (optic nerve) is damaged. This damage often goes along with higher pressure in the eye. The damage can lead to a loss of vision. However, early treatment can prevent vision loss. If you need treatment, your eye doctor may recommend medicine, laser treatment, and possibly surgery to reduce the pressure in one or both eyes.

What are the different types of surgery for glaucoma?

Surgery involves either laser treatment or making a cut in the eye to reduce the pressure in your eye. The type of surgery you have depends on the type and severity of your glaucoma and other health problems you may have. Surgical procedures for the treatment of glaucoma are:

• Laser trabeculoplasty: The surgeon uses a laser to increase the fluid drainage from tissue near the base of the colored part of the eye called the trabecular meshwork. This procedure is used to treat open-angle glaucoma.
• Laser iridotomy: The surgeon uses a laser to make a small hole in the iris to allow fluid to drain and reduce pressure in the eye. Most cases of angle-closure glaucoma can be treated with laser iridotomy.
• Filtering surgery: The surgeon removes a very small piece of the wall of the eye (the sclera). Fluid can then drain through the hole that this creates. The most common type of filtering procedure is called a trabeculectomy. This type of surgery is used for several types of glaucoma.
• Cyclodestructive procedures: In some cases of glaucoma, it may be necessary to destroy certain areas of the ciliary body (the part of the eye that produces fluid). A laser or freezing instrument is used.
• Shunt procedure: The surgeon places a tube inside the eye. The tube helps the fluid drain from the eye. This surgery is used for several types of glaucoma.

What happens after glaucoma surgery?

• You will probably be able to go home the day of the surgery.
• One or both of your eyes may be bandaged. Because you will not be able to use the bandaged eye(s), you will need to arrange for someone to drive you home.
• If one eye is bandaged, you may notice changes in your depth perception. You will need to be careful so that you do not fall.
• You may have some pain in your eye. Your doctor will give you medicine for the pain.
• The doctor may need to examine your eye and measure the pressure the day after surgery.

How can I take care of myself?

• Carefully follow the treatment prescribed by your doctor.
• After filtering surgery, your doctor may want you to use an eye shield to protect your eye from injury.
• Follow your doctor's instructions for patching the eye.
• Follow your doctor's instructions for using eyedrops or ointment to prevent infection and reduce inflammation and scarring. Wash your hands with soap and water. Put drops or ointment in the eye by pulling down the lower lid and placing 1 to 2 drops or a short ribbon of ointment along the inside of the lower lid. Do not touch the tip of the applicator to your eye.
• If your eye develops any of the following signs of infection, tell your doctor immediately:
  • severe or worsening pain
  • worsening redness
  • increasing swelling
  • loss of vision
  • a lot of eye drainage with pus.
• Do not rub your eye unless your doctor tells you to massage your eye.
• Avoid contact sports, strenuous work, swimming in pools or hot tubs, bending over, and lifting heavy objects for 2 weeks after the surgery.