If medicine or laser surgery does not relieve eye pressure, a patient may need glaucoma surgery. There are several options.
Filtering surgery ► Filtering surgery ▼
In the most common filtering surgery, called a trabeculectomy or a sclerostomy, the surgeon makes a small opening in the white part of the eye (the sclera) to create a new outflow path. The fluid then flows through the new opening and creates a bleb, which is like a small bubble or reservoir on the surface of the eye. The bleb holds the fluid while it is slowly absorbed into the surrounding tissue. The upper eyelid usually hides the bleb, so it's not noticeable to you or others.
Most people who have this procedure no longer need medicine after surgery. Some people treated still need medicine, but they have better pressure control after the surgery. About 15 percent do not benefit from filtering surgery.
An alternative type of glaucoma surgery may occasionally be performed in which the tissues over the drainage area are thinned but not fully penetrated. This procedure may produce fewer complicatons than trabeculectomy, but also may be less effective in achieving low intraocular pressures.
Drainage implant surgery ► Drainage implant surgery ▼
In these procedures, the surgeon inserts a tiny tube through the sclera into the front part of the eye behind the iris. This tube becomes a path for fluid to drain away. The other end of the tube is attached to a tiny reservoir that acts like the bleb to hold fluid until it is absorbed into the surrounding tissue. The reservoir is placed on the surface of the eye, back between the eye muscles, so it is not visible.
Right after filtering or drainage implant surgery, a person may have a temporary decrease of vision. Vision usually improves over several weeks to its previous level. It also takes time to recuperate from either form of surgery. For example, in the weeks after surgery, people often must avoid getting water into their eyes, reading, bending, lifting heavy objects and driving.
Canaloplasty ► Canaloplasty ▼
Minimal Invasive Glaucoma Surgeries ► Minimal Invasive Glaucoma Surgeries ▼
Laser Cyclophotocoagulation ► Laser Cyclophotocoagulation ▼
Risks of glaucoma surgery ► Risks of glaucoma surgery ▼
Glaucoma surgeries have some possible risks, such as:
- A higher chance of getting cataracts
- Infection or leaking of the incision
- Too low pressure
- Hemorrhages inside the eye
Unfortunately, the new drainage path can close, causing pressure in the eye to rise again. Filtering surgery can be repeated with good results. Also, drainage implants are often successful in patients whose filtering surgery has failed. The medicines that reduce inflammation and control scar formation after surgery have helped increase the success of glaucoma surgeries.