Glaucoma Surgery Co-Management

When is surgery used for glaucoma treatment?

Typically, glaucoma surgery is not the initial treatment approach for managing the condition. However, when alternative treatments prove ineffective, glaucoma surgery can potentially preserve your vision.

The primary objective of glaucoma treatment is to reduce intraocular pressure and promote fluid drainage. Elevated pressure can exert force on the optic nerve, leading to vision damage. While medicated eye drops are commonly prescribed to lower pressure levels, they may not be effective for everyone, particularly in cases of high pressure or when side effects are a concern. In such situations, glaucoma surgery may be recommended by your Child & Family Eye Care eye doctor.

Types of Glaucoma Surgery

Glaucoma surgery options include laser procedures, which are typically performed on an outpatient basis. These laser surgeries encompass:

• Argon laser trabeculoplasty (ALT): Opens blockages in the eye, facilitating proper fluid drainage.
• Selective laser trabeculoplasty (SLT): Utilizes a low-level laser to target specific areas with elevated pressure, when ALT is not fully effective.
• Laser peripheral iridotomy (LPI): Creates a small opening in the iris using a laser beam, allowing excess fluid to drain in cases of narrow-angle glaucoma.
• Cyclophotocoagulation: Involves directing a laser beam through the sclera into the ciliary body to reduce the production of intraocular fluid when other laser treatments do not suffice.

In cases where laser surgery does not adequately lower eye pressure, alternative procedures may be considered, such as:

• Trabeculectomy: Involves making a small incision in the white part of the eye to remove a portion of the inner tissue mesh, facilitating fluid drainage. Medication may be used to prevent scar tissue formation. Trabeculectomy has shown to effectively reduce eye pressure in 6-8 out of 10 individuals and is particularly beneficial for those without previous eye trauma or surgery.
• Drainage implant surgery: Involves the insertion of a small tube inside the eye to promote fluid drainage. Various minimally invasive implants are available.
• Electrocautery: Uses a heat device called a Trabectome to create a small incision in the drainage tubes of the eye, delivering heat to the inner tissue mesh and relieving fluid pressure. Electrocautery is a less invasive alternative to trabeculectomy or drainage implants.