Glaucoma surgery

Glaucoma surgery offers various approaches to manage elevated eye pressure, a key factor in the progression of this condition. From minimally invasive procedures to traditional surgeries and laser treatments, there are options designed to improve fluid drainage within the eye. If you’re exploring glaucoma treatment, understanding these surgical possibilities can help you discuss the best course of action with Regency Eye Hospital.

Conservative treatment
First line treatment for treatment of glaucoma is usually eye drops or selective laser trabeculoplasty (SLT).

There are a large variety of eye drops for glaucoma management. These all work either by reducing the production of aqueous humour (fluid in the eye) or improving drainage. SLT treatment can also be used to improve drainage of aqueous humour and lower eye pressure. Without laser or surgical intervention, it is likely that you will need eye drops for your lifetime. SLT can reduce or remove the need for eye drops.

Surgical treatments
Trabeculectomy surgery
In this surgery a new drainage channel is created to lower pressure. In this procedure, a small flap is created in the sclera (white part of the eye) to allow excess fluid to drain out.

Glaucoma Drainage Devices
A small implantable device (such as an Ahmed valve or Baerveldt implant) is inserted into the eye to help drain excess fluid and lower intraocular pressure. Surgery is usually performed under local anaesthesia or twilight anaesthesia. A small incision is made in the eye to create a pathway for the device to be inserted. This implant is carefully positioned in the eye, usually in a region behind the iris. A small tube connected to the device is inserted into the eye to facilitate the drainage of aqueous. In all cases, the aim of the treatment is to lower the intraocular pressure and thereby limit further optic nerve damage and slow down further progression of the condition.

MIGS (Minimally invasive glaucoma surgery)
MIGS covers a few procedures such as iStent, Hydrus Microstent or Trabecome. These procedures aim to improve drainage of aqueous humour and reduce eye pressure with minimal intervention.

The choice of procedure depends on various factors such as the type and severity of glaucoma. Other considerations include the likelihood that the patient is able to keep compliance to daily regimes such as drops.