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Glucoma Surgery

Surgery involves either laser treatment or making a cut in the eye to reduce the intraocular pressure. The type of surgery your doctor recommends will depend on the type and severity of your glaucoma and the general health of your eye.

Surgery can help lower pressure when medication is not sufficient. However, it cannot reverse vision loss.


Laser Surgery

Doctors often recommend laser surgery before filtering microsurgery, unless the eye pressure is very high or the optic nerve is badly damaged. During laser surgery, a focused beam of light is used to treat the eye's trabecular meshwork (the eye's drainage system).This helps increase the flow of fluid out of the eye.


Conventional Surgery

In contrast, conventional surgery (filtering microsurgery) involves creating a drainage hole with the use of a small surgical tool. This new opening allows the intraocular fluid to bypass the clogged drainage canals and flow out of this new, artificial drainage canal.
When laser surgery does not successfully lower eye pressure, or the pressure begins to rise again, the doctor may recommend conventional surgery. If necessary, Glaucoma Treatment can be done several times without substantial risk.


When Is Glaucoma Treatment Needed?

Depending on the type of glaucoma you have, different treatment options may be considered.
Glaucoma Treatment creates a new opening for fluid drainage. Graphic (enhanced) courtesy of National Eye Institute, National Institutes of Health.
Non-surgical options include the use of topical eye medications (glaucoma eye drops) or oral medications (pills).
Most cases of glaucoma can be controlled with one or more drugs. But some people may require surgery to reduce their IOP further to a safe level by improving the outflow or drainage of fluids. Occasionally, surgery can eliminate the need for glaucoma eye drops. However, you may need to continue with eye drops even after having Glaucoma Treatment.
Some recent studies indicate that a laser procedure known as selective laser trabeculoplasty (SLT) may be equally as effective as glaucoma eye drops for lowering internal eye pressure. This laser surgery might be considered a primary treatment, particularly for people who find it difficult to comply with the strict, regular schedule needed for administering eye drops.
Another procedure called a trabeculectomy creates an artificial drainage area. This method is used in cases of advanced glaucoma where optic nerve damage has occurred and the IOP continues to soar. A third common option is a shunt, a device that a surgeon implants in your eye to improve fluid drainage.

Benefits Typically Outweigh Risks for Most Advanced Cases

There are risks with any type of surgery, and the risks for Glaucoma Treatment are discussed in this article so that you can have an open dialogue with your ophthalmologist. It is important to note, however, that Glaucoma Treatment is very successful at substantially slowing the progression of glaucoma and achieving the intended eye pressure. Furthermore, if glaucoma is inadequately treated, it is almost certain that vision will be lost.

Although Glaucoma Treatment can prevent further vision loss and on rare occasions improves vision, damage that has already occurred as a result of glaucoma is considered permanent and not yet reversible.

Vision Loss

It is important to understand that vision can be reduced or even, in very rare instances, totally lost as a result of any of these glaucoma operations; however, vision loss is not a common side effect. Therefore, it is more likely that surgery will benefit your vision in the long run.

Bleeding

With any of these operations, complications can occur even with the best surgical techniques. Uncommon or rare complications include bleeding inside the eye, infection, and fluid pockets behind the retina due to very low eye pressures. Bleeding inside the eye can be a very serious complication, so you should talk with your ophthalmologist if you are on blood thinners and follow his/her instructions about continuing or discontinuing the medication prior to surgery

Infection

Eye doctors give antibiotics before, during, and after the surgery, as well as maintain meticulous sterile techniques to try and avoid any infection. However, on very rare occasions, infection inside the eye may occur, which can be very serious and may threaten vision. These infections can occur weeks, months, or even years after the surgery. Therefore, if you have early signs of infection such as redness, pain, or excessive tearing, you should see your ophthalmologist immediately in order to treat infection before it becomes serious.

Low Eye Pressure

Sometimes, the surgery can lead to eye pressures that are too low, also called hypotony. This is more common soon after the surgery. With hypotony, fluid may collect behind the retina (choroidal detachment), which can cause a shadow in your peripheral or side vision. Usually this is temporary as the pressure returns to the levels that were intended. Sometimes, however, hypotony persists and surgery must be performed in order to fix this problem.

Scarring

More common than causing eye pressure that is too low, these glaucoma surgeries may fail over time due to the natural healing or scarring tendencies of the eye, resulting in eye pressures that are higher than intended. Sometimes, the scarring is so intense that the operation may fail to achieve a lowered pressure and you may need to restart your glaucoma medications or undergo repeat surgery.

Cataract

Cataract formation most likely will be accelerated by Glaucoma Treatment, but luckily cataracts are fairly easy to fix surgically. Sometimes glaucoma surgeries are combined with cataract surgery if your ophthalmologist feels that the cataracts are having a moderate to significant impact on your vision.



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