Understanding glaucoma surgery
 

Glaucoma is a very serious condition that is actually a bunch of diseases working together that cause damage to the optic nerve.  The problem with this condition is that there may not be any symptoms and damage may be done before it is diagnosed. 

Doctors usually start with treatments that are related to medications as well as physical therapy, but if these things are not successful glaucoma surgery is called for.  Most doctors will put off surgery for as long as possible, because though it has become a relatively routine procedure, most doctors are hesitant to perform surgery on the eyes unless all other therapies have failed or there is an emergency that requires the surgery.

There are two types of glaucoma eye surgery, one that uses a laser and one that requires traditional surgery:

1. The laser glaucoma surgery is performed by aiming a laser light at the eye’s trabecular meshwork to open up the blockages in this meshwork to increase the flow of aqueous fluid from the eye. 

2. The traditional surgery is commonly called filtering microsurgery.  This requires that a hole be made to allow excess fluids to drain from the eye.  Draining the fluid from the eye will reduce the pressure in the eye, which is the purpose of the surgery.

Laser surgery is becoming more common than the traditional incision type eye surgery

There are actually four types of laser surgeries known as:

  • SLT - is the acronym for selective laser tubeculoplasty and is used to reduce the pressure by enhancing drainage of excess fluid.  This type of treatment can be repeated to treat specific cells in the meshwork. 

  • ALT - is short for argon laser trabeculoplasty and reduces pressure in the eye by opening the drainage canals of the eye.

  • LPI - is used for narrow angle glaucoma and relieves pressure by making a hole in the iris of the eye so that the iris can move back from the cornea to allow more aqueous flow.

  • Laser cyclophotocoagulation - is a procedure that produces aqueous flow by treating the ciliary body.

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Traditional surgery is still used for patients, but laser is preferred as patients typically respond and heal better to it.  Traditional surgeries will be used when medication and laser procedures have failed.

There are risks associated with glaucoma surgery, but they are not greater than the risk of leaving the eye untreated.  Glaucoma affects the optic nerve, eventually causing blindness if treatment is not sought.  Glaucoma surgery has become much easier and more effective over the last several years, making it a viable option for more and more people.