Glaucoma Surgery

Glaucoma is a condition of high pressure inside the eyes. There are several forms of glaucoma. The pressure in the eye is raised because fluid (aqueous) within the eye cannot get out through the normal drainage system.

SURGICAL PROCEDURES FOR GLAUCOMA

Surgery to reduce the pressure within the eye can involve either:

  • Laser treatment.

  • Making a cut by the surgeon (incision) in the eye.

Four common surgical procedures are used for the treatment of glaucoma.

  • Iridotomy. This type is used for treating angle-closure glaucoma in which fluid builds up behind the colored part of the eye (iris ) and cannot flow into the front (anterior) chamber for drainage.

  • Laser iridotomy uses a laser to make a small opening in the iris. This will lessen pressure in the eye and allow fluid to drain. Most cases of angle-closure glaucoma can be treated with laser iridotomy.

  • Ripheral Iridectomy is a procedure in which a small opening is made in the iris surgically instead of using a laser.

  • Laser trabeculoplasty. A laser is used to enlarge the drainage openings near the base of the iris (called the filtration angle). This procedure is used to treat open-angle glaucoma.

  • Filtering surgery. A small button of sclera is removed. This allows the fluid to seep under the conjunctiva (a membrane which covers the inside of the eyelid), thus lowering eye pressure. The most common type of filtering procedure is a trabeculectomy. Unlike laser procedures, this type of surgery is performed in an operating room. It is used for a number of types of glaucoma.

  • Cyclodestructive procedures. In other types of glaucoma, it may be necessary to destroy part of the eye that produces fluid (ciliary body). A laser or freezing instrument is used.

AFTER THE PROCEDURE

  • You may lose part or all of your vision for a while.

  • There will be changes in depth perception.

  • It will be hard to walk stairs.

  • Do not drive.

  • You may receive medications for discomfort.

  • Glaucoma surgery is often done on an outpatient basis. The surgeon may need to examine the eye and measure the pressure later the same day of the surgery or the day following.

HOME CARE INSTRUCTIONS

  • Follow carefully the treatment prescribed by your caregiver.

  • After filtering surgery, your surgeon may want you to use an eye shield to protect your eye from injury.

  • Patch your eye as directed. Wash your hands before using any eye drops or ointment. Apply eye drops or ointment as needed. Put drops or ointment in the eye by pulling down the lower lid. Place a line of ointment or 1 to 2 drops along the inside of the lower lid. Do not touch the tip of the applicator to the eye.

  • Watch for signs of infection, including:

  • Increased pain.

  • Redness (inflammation).

  • Swelling.

  • Visual changes.

  • Pus- like drainage.

If your eye develops any of these signs, tell your caregiver right away.

  • Avoid:

  • Rubbing your eyes.

  • Smoking.

  • For 1 to2 weeks, avoid:

  • Contact sports.

  • Strenuous yard work.

  • Housework.

  • Swimming.

  • Lifting heavy objects.

SEEK MEDICAL CARE IF:

  • You notice signs of infection in your eye.

  • You develop increased pain, redness (inflammation) or swelling.

  • You notice visual changes or a pus- like drainage.