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Glaucoma Surgery: 5 Facts You Need to Know

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glaucoma surgery

Last Updated on October 5, 2021 by ashley.davis

Introduction

The ability to see is a precious gift. With it, you can fully experience the world around you. If you’re facing a loss of vision or glaucoma-related issues, there’s no need to feel alone. More than 3 million Americans have glaucoma, while over 80 million people have the condition worldwide. This number will likely increase by 2040. Glaucoma surgery could be your best solution.

To check if you have glaucoma, your optometrist or ophthalmologist will conduct specialized tests. They will then give you an official diagnosis. Depending on the results, you may need to consider glaucoma surgery. We’ll talk more about it in this article. 

Introduction to Glaucoma and Glaucoma Surgery

Glaucoma Surgery

We’ve reached out to Dr. Pradeep Ramulu, (M.D Ph.D.) glaucoma specialist and director of the Wilmer Eye Institute at John Hopkins Medicine. He provided us with his insight on the topic. 

Glaucoma is a disease in which the optic nerve is damaged in a specific way,” explains Dr. Pradeep Ramulu. “The optic nerve is important because it relays information from the eye to the brain. When the nerve is damaged, the brain does not receive information regarding what the eye has seen, leading to damage to one’s eyesight.

To be directed to Dr. Ramulu’s contact page, please click here

Fortunately, medical science has made great strides. Many discoveries and progressive research on glaucoma have taken place over the years. For this reason, glaucoma surgery has become a common method to treat and manage this condition.


Glaucoma surgery can range from virtually risk-free procedures done in the clinic to complex procedures that require a trip to the operating room. All glaucoma surgeries have the goal of lowering the eye pressure, as glaucoma worsens less often or more slowly at lower eye pressures,” explains Dr. Pradeep. “This depends greatly on many factors, including the type of surgery being considered, how severe the glaucoma is, and other features of the eyes,” 

Dr. Pradeep also says that generally, the success rates for this type of surgery are high for all procedures—more so if we define success as lowering eye pressure to a level of 18 mm Hg with the possible use of medications. 

Yet, when you need to reduce eye pressure to a more moderate level and cut the need for eye drop medications, the success rate is usually lower. 

An official diagnosis can help to ease any anxiety you may have. 

“Glaucoma is a disease in which the optic nerve is damaged in a specific way. When the nerve is damaged, the brain does not receive information regarding what the eye has seen, leading to damage to one’s eyesight.”

Dr. Pradeep Ramulu, Glaucoma Specialist, Wilmer Eye Institute

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What Is Glaucoma? 

Glaucoma Surgery

Glaucoma is an eye disease caused by the pressure inside your eye. Your eye has passages that contain fluids. When these passages become blocked or clogged, the pressure inside your eye increases. 

Glaucoma occurs when this pressure affects your optic nerve, resulting in lower vision and, in severe instances, blindness. 

There are two primary forms of glaucoma: 

  1. Open-angle glaucoma 
  2. Angle-closure glaucoma 

Open-angle glaucoma

Open-angle glaucoma, the most common form, doesn’t have any symptoms at the start. At some point, the symptoms occur, and total vision loss may result. Angle-closure glaucoma

Angle-closure glaucoma occurs when the natural flow of the fluid between the iris and the lens is blocked. You may experience severe pain, vomiting, blurred vision. You may also see rainbow halos that appear around lights.

It’s crucial to release the pressure caused by the fluid in your eye. You’ll need to go for checkups often to manage the condition. If you experience vision loss, contact your doctor immediately. 

1. What Does Glaucoma Surgery Entail? 

Glaucoma Surgery

Before worrying about the cost, focus on how it can improve your quality of life. Glaucoma Surgery is a medical procedure that takes the pressure off the eye. It also helps to prevent further damage to the optic nerve connected to the brain. Your glaucoma surgery’s cost may differ depending on the type of surgery you need. 

There are various types of surgeries related to glaucoma. These include:

  • Laser
  • Trabeculectomy 
  • Glaucoma Implant Surgery 
  • Minimally Invasive Glaucoma Surgery (MIGS) 
  • Electrocautery

Here’s a brief description of what these surgeries entail.

Laser surgery

Laser surgery for glaucoma is a procedure to lower the pressure on your eye. A tiny and powerful light shrinks the clogged areas on your eyes. By doing so, it helps to drain the fluid that causes the strain.

Doctors will suggest laser treatment if other medicines haven’t lessened your eye pressure.

Trabeculectomy

A Trabeculectomy usually treats open-angle glaucoma. This type of glaucoma surgery usually takes about an hour or even less.  The surgeon creates a tiny opening at the top of your eye under your eyelid. The incision will be small and won’t be visible. The incision allows the drainage of the extra fluid from your eye. The pressure in your eye will then lessen.

Glaucoma implant surgery 

Glaucoma Implant Surgery is an option for when other procedures have not worked. 

You may also consider it if you’ve received a diagnosis of congenital glaucoma. Also, if you’ve injured your eye or if your condition relates to diabetes. The surgeon will place an implant on the outside of your eye. A small tube will be inserted into the front chamber of the eye.  The implant provides a passageway for the fluid to flow and lessens the eye pressure.

Minimally Invasive Glaucoma Surgery (MIGS)

MIGS is a relatively new type of treatment but poses fewer risks than traditional surgical treatments. It’s best suited for mild to moderate glaucoma and is relatively fast. MIGS can’t reverse the damage caused to your eye but it can help prevent further damage to your vision. 

Electrocautery

Electrocautery is a procedure by which your doctor will use a device called a Trabectome to project heat onto your eye. This heat will create an incision to drain the fluid trapped in your eye passages. Electrocautery isn’t as invasive as the other surgical treatments that were mentioned.

Remember, glaucoma surgery is only taken into account once the eye specialist has treated you in several ways. For example, prescription eye drops or oral medication to release the pressure on your eye(s). There may be side effects. Make sure to speak to your specialist about alternatives and the best options for you.

If you have glaucoma in both your eyes, you probably won’t have both operated on at the same time. Instead, your doctor will most likely operate on one eye at a time. You can find out an estimate about the glaucoma surgery cost here.

2. How Successful Is Glaucoma Surgery? 

Glaucoma Surgery

The Glaucoma Research Foundation states that Selective Laser Trabeculoplasty (SLT) can lower eye pressure by up to 30%. Other similar studies have shown a follow-up period of 1 year. Those reports show that glaucoma filtering surgery is successful in about 70-90% of cases in patients who are older.

After a while, the drainage hole may close because the body will try to heal the surgically-created opening. It’s as though the body deems the drainage hole as an injury. Anti-wound healing medication such as mitomycin-C and 5-FU can slow the healing process. There are circumstances in which you may need glaucoma surgery more than once. 

It’s essential to attend your regular checkups with your doctor. Taking care of your eyes after surgery is the most effective way to manage your condition. Only by doing so will your surgery have a greater chance of giving you a good result. It’s also in your best interest to do everything possible to prevent further damage.

3. Can Glaucoma be Cured with Surgery?

According to the Glaucoma Center of Excellence, there’s no complete cure for glaucoma. Yet, some treatments can slow its progression and provide comfort. It’s important to discuss all your options with your doctor. It’ll help you take care of your eyes in the best way possible. 

Dr. Pradeep elaborates: “One can never consider oneself cured of glaucoma surgery. Once given the diagnosis, you should continue to follow up with a doctor for life. Surgery, when successful, can lower the eye pressure and eliminate the need for eye drops, but no surgery can be guaranteed to work forever.

Glaucoma may cause your eyes to become dry, and your eyes may be sensitive to wind. There are some natural remedies. An affordable remedy is to use a warm compress on your eyes. 

The warm compress will ease the sensitivity and encourage good blood flow to your eyes. Boil some water until it steams, dip a fresh cloth into the water and wring it out to remove excess water. Then place the cloth onto your eyelids for a short while at a time. You’ll need to do this a few times over several minutes to get some relief.

It is also a good idea to eat foods that contain Omega 3s, such as fatty fish. The fatty acids in these foods can help prevent and ease your dry eyes.

Many eye drops use castor oil because of its anti-inflammatory properties. It helps to reduce and treat inflammation, and guards and treats infections. 

4. How Long Does It Take to Recover from Glaucoma Surgery?

Glaucoma Surgery

Your recovery time depends greatly on the type of surgery you have,” says Dr. Pradeep. “Some office procedures such as SLT allow for a full recovery within hours. Surgery done in the operating room can involve a recovery of days to weeks.

He further explains that the answer also depends on your expectations. 

For most operations, vision is unlikely to drop well below the starting level after surgery (though it can happen). Thus, nearly all patients can perform routine self-care tasks. But when you can drive and work depends on many factors including your level of visual damage, the health of the eye not being operated on, your other medical conditions, and the type of operation you are having.

The doctors will suggest standard aftercare for you to recover successfully. Glaucoma recovery after surgery shouldn’t take any longer than 3 to 4 weeks. Only rarely does recovery take a few months, but this isn’t usual. You should also not perform strenuous actions.

Doctors will also tell you not to lift heavy objects or do excessive physical activities. It would be best if you don’t strain yourself until your eye has completely healed. You have to attend your regular checkups to keep track of your progress. 

If you need someone to care for you after your surgery, a Home Care agency can help you find a suitable caregiver.

5. Will I be Put to Sleep for Glaucoma Surgery?

Glaucoma Surgery

One is put to sleep completely only in rare circumstances,” says Dr. Pradeep. “Surgeries done in the operating room are typically done with intravenous sedation – meaning you are awake, but given medicines through your vein to help you relax.”

For Laser surgery or Trabeculectomy surgery, you’ll likely be awake during the procedure. The doctor will give you a few numbing eye drops before the surgery to help you relax. You’ll most likely be able to go home the very same day, but someone else will need to drive. 

The best way to prepare for glaucoma surgery is to ask your eye specialist about your procedure. Also, confirm with your doctor whether you’re not allowed to eat before the surgery takes place. 

If you’d like, ask for a rundown of what will happen so that you have a clear picture. It’s always a good idea to ask your doctor the questions that you’re afraid to ask. 

If you’d like to know if you’ll be put to sleep during surgery, ask questions related to the anesthetist handling your surgery. This specialist will always have your best interest at heart and can give you clear answers to your questions. 

Top 5 Points

1. There are different types of glaucoma surgery (Laser, Trabeculectomy, Glaucoma Implant Surgery, Minimally Invasive Glaucoma Surgery, Electrocautery)
2. The Glaucoma Research Foundation states that Selective Laser Trabeculoplasty (SLT) can lower eye pressure by up to 30% 

3. While there’s no complete cure for glaucoma, some treatments can slow its progression and also provide comfort.

4. Glaucoma recovery after surgery shouldn’t take any longer than 3 to 4 weeks. It will greatly depend on the type of surgery you have.

5. It’s rare to put patients to sleep for glaucoma surgery. You’ll likely be awake during the procedure, but the doctor will give you numbing eye drops beforehand.

Conclusion 

You have the necessary facts at hand. You’re now able to make an informed decision. It’s still crucial to get a clear understanding of your situation. Gather information on your diagnosis with your eye specialist. Make sure you have all your boxes ticked.

Your sight is one of the most valuable senses that you have. It’s essential to call your doctor as soon as you suspect that your eyes need treatment. Do all that you can to prevent further damage. 

At the very least, attend your annual eye appointment to ensure that your eyes are well. There are many treatments to consider. Your doctor will help you find the best options for you. Please don’t speculate.

Have you already booked an appointment? Well done on the bold step towards taking care of your health! Remember to consult your eye specialist throughout your recovery process. Taking care of your eye health will help you maintain a good quality of life. 

Check out our Health & Fitness article on IADL vs. ADL.

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