Glaucoma Surgery

Sometimes, when medication is not producing the desired reduction in eye pressure, your doctor may suggest surgery. Glaucoma surgery involves either laser treatment or filtering microsurgery to reduce fluid build-up in the eye which, in turn, reduces intraocular pressure. Your doctor will recommend the best surgical treatment depending on the type and severity of your glaucoma and the general health of your eye. Surgery can help lower eye pressure when medication is not sufficient, however surgery cannot reverse vision loss.

Laser surgery is often recommended before filtering microsurgery unless eye pressure is very high or the optic nerve is badly damaged. During laser surgery, a tiny but powerful beam of light is used to make several small scars in the eye’s trabecular meshwork (the eye’s drainage system). The scars help increase the flow of fluid out of the eye which lowers the intraocular pressure.

When laser surgery does not successfully lower eye pressure, or the pressure begins to rise again, the doctor may recommend filtering microsurgery. This surgical procedure, called a trabeculectomy or sclerostomy, involves creating a tiny drainage hole in the sclera (the white part of the eye) with a small surgical tool.

In most cases, there is no pain involved during either laser treatment or microsurgery because local anesthetic and relaxing medications are used. Both are outpatient procedures. Within a few days after surgery, you will have a follow up appointment with your eye doctor to check eye pressure and look for any signs of infection or increased inflammation

In general, patients can resume normal daily activities the next day after laser surgery. For at least one week after filtering microsurgery, patients are advised to keep water out of the eye and avoid driving, reading, bending and doing any heavy lifting.

Following both laser and filtering microsurgery, medications often continue to be necessary in order to control and maintain eye pressure. Surgery may, however, lessen the amount of medication needed. Although there is a small risk of developing cataracts after some types of surgery for glaucoma, the potential benefits of surgery usually outweigh any risks.

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