Surgery for glaucoma is an option when medications and laser cannot lower the pressure enough. Surgery is done as an outpatient surgery with local anesthesia
There are many types of procedures that are now available. Your doctor will recommend the best procedure for your eyes based on the type of glaucoma
Minimally Invasive Glaucoma Surgery (MIGS) are a group of advanced, microsurgical procedures designed to lower intraocular pressure in patient with mild to moderate glaucoma. These procedures work by improving the outflow of the drain using microscopic equipment to enhance the natural drainage system. Some MIGS procedures use a laser to treat the ciliary body cells which lowers the eye pressure by decreasing the amount of aqueous fluid produced. MIGS procedures can also be combined with cataract surgery.
The advantage of MIGS procedures are that they have minimal tissue disruption, and lower risk of severe complications. While safer, the overall pressure lowering for MIGS procedures may be less than traditional invasive surgery.
Request an AppointmentCurrently Dr. Hall performs a wide variety of MIGS including goniotomy, Transluminal dilation of Aqueous Outflow Canal, Viscodilation, and Canaloplasty.
Implantable drug delivery systems are also an option. These are tiny, biodegradable sustained-release drug systems injected directly into the eye. These systems eliminate the need for daily eye drops by slowly releasing medication to lower the intraocular pressure in the eye.
Glaucoma (filtering) surgery is incisional glaucoma surgery, that refers to either trabeculectomy or a tube shunt procedure. Either type is done on an outpatient basis either at a hospital or surgery center facility. Both of these procedures can potentially lower your eye pressure a great deal and place your glaucoma under better control, reducing the risk for blindness.
A trabeculectomy involves making a “trap door” out of the wall of the eye, thus making a new drain in your eye, and allowing another place for fluid to drain from your eye, reducing the eye pressure. The result is a blister or a “bleb” on the surface of the eye, located under your upper eyelid.
A tube shunt is a device that is implanted on the eye, with the tube entering the eye to “shunt” fluid from inside the eye to the plate on the surface of the eye. The plate is covered by your own tissue (conjunctiva) and, in most cases, is normally not visible.
Depending on the type and severity of glaucoma, and how much pressure-lowering is required, other treatment procedures are available. Aqueous shunt, or “tube” surgery is usually recommended in certain types of glaucoma with a lot of associated inflammation, such as uveitis or neovascular glaucoma. A shunt drains excess fluid from a tiny tube inside the eye which is attached to a small reservoir on the eye.
Another option for pressure lowering is cyclophotocoagulation, which is a laser used to reduce the amount of fluid produced in the eye. This is generally used to treat very advanced or aggressive glaucoma.