Understanding Glaucoma Surgery: Types and Procedures

Glaucoma is a group of eye conditions that affect the optic nerve and can lead to vision loss or blindness if left untreated. It is caused by increased pressure in the eye, which damages the optic nerve over time. While glaucoma can be managed with eye drops, medication, or laser treatment, some patients may require surgery to prevent further vision loss. In this article, we will discuss glaucoma surgery, including its types and procedures.

Types of Glaucoma Surgery

Trabeculectomy
Trabeculectomy is the most common type of glaucoma surgery. It involves creating a small hole in the eye to allow excess fluid to drain out of the eye, which reduces the pressure inside the eye. During the procedure, the surgeon removes a small piece of tissue from the white part of the eye, creating a flap that covers the hole. The flap acts as a valve to regulate the flow of fluid out of the eye.

Tube Shunt Surgery
Tube shunt surgery is a procedure in which a small tube is implanted in the eye to drain excess fluid from the eye. The tube is connected to a reservoir, which is placed beneath the conjunctiva (the clear layer of tissue that covers the white part of the eye). The reservoir acts as a storage space for the fluid before it is absorbed by the body.

Laser Surgery
Laser surgery is a minimally invasive procedure that uses a high-energy laser to create small openings in the eye’s drainage system. This allows excess fluid to drain out of the eye, reducing pressure and preventing damage to the optic nerve. There are different types of laser surgery, including selective laser trabeculoplasty (SLT), argon laser trabeculoplasty (ALT), and diode laser cyclophotocoagulation.

Procedures for Glaucoma Surgery

Pre-operative Evaluation
Before undergoing glaucoma surgery, the patient will undergo a thorough eye examination to evaluate the severity of their condition and determine the best course of treatment. This will include measurements of the intraocular pressure, visual field testing, and imaging of the optic nerve.

Anesthesia
Glaucoma surgery is usually performed under local anesthesia, which numbs the eye and the surrounding area. In some cases, the patient may be given sedatives to help them relax during the procedure.

Surgery
The surgeon will create a small incision in the eye and remove a small piece of tissue to create a flap. In trabeculectomy, the flap is left partially attached to the eye, acting as a valve to regulate the flow of fluid out of the eye. In tube shunt surgery, the tube is implanted in the eye, and the reservoir is placed beneath the conjunctiva. The surgeon will then close the incision with sutures.

Post-operative Care
After glaucoma surgery, the patient will be given eye drops to prevent infection and reduce inflammation. The patient will also need to avoid strenuous activities, heavy lifting, and rubbing their eyes for several weeks after surgery. The surgeon will schedule follow-up appointments to monitor the patient's progress and adjust their treatment as necessary.

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