Glaucoma - Surgery
Both laser and conventional surgeries can be used to prevent closure of
the drainage angle. These procedures involve making a new opening in the
colored part of the eye (iris) that allows fluid to flow through the eye. They
are used to treat sudden (acute) closed-angle glaucoma and will prevent
closed-angle glaucoma in people who have narrow drainage angles. Laser
iridotomy can usually be done instead of surgical iridectomy. But some people
with complicated or severe glaucoma may need to have surgical iridotomy.
Surgery to decrease the amount of fluid produced in the eye
When other surgery fails to improve the flow of fluid from
the eye, procedures to destroy the part of the eye that produces fluid (ciliary
body) can be done. These procedures are also used when scar tissue has formed
after a previous surgery.
Destroying the ciliary body decreases
the amount of fluid produced in the eye, reducing the pressure in the eye.
Procedures that decrease fluid in the eye are only used for people with severe
glaucoma that has not gotten better after they have tried medicines or other
forms of surgery.
Surgery for congenital glaucoma
glaucoma, there are two slightly different procedures that both attempt to open
the drainage angle directly. They are equally successful in children, but they
are not used for adults. If these procedures fail in a child, then
trabeculectomy or tube-shunt (seton glaucoma) surgery may be tried.
What to Think About
Clouding of the lens (cataract) can develop after surgery for glaucoma and
is one reason that surgery is not usually used first to treat open-angle
Cataracts may occur in people who also have glaucoma. This commonly occurs in older people. Surgery to remove the cataract may be
done at the same time as surgery for glaucoma. If
surgery for glaucoma and a cataract are done at the
same time, you may notice improved eyesight after surgery.
decision whether or not to have surgery is often more difficult in glaucoma
than in many other conditions because:
- In many instances, the person is not in pain
and often does not notice any vision loss.
- Surgery often causes a
person's eyesight to get worse immediately after surgery. Vision may be
affected for weeks or months after surgery. For some people, their eyesight is
never as good as it was before the surgery. Surgery is not a complete cure for
glaucoma. But surgery can decrease the chance of losing even more eyesight
- Not everyone who has laser surgery will have lower
intraocular pressure after the surgery. For some people, the lower pressure
will last only a few years. Others may have an increase in their eye pressure.
Certain types of open-angle glaucoma respond better to laser surgery than
- The effects of some laser treatments are not long-lasting.
Repeat laser treatments, medicines, or other surgeries may be needed later