Our Summary

The current best treatment for glaucoma (a condition that damages your eye’s optic nerve) is a surgery called trabeculectomy, but this only works if regular medication isn’t doing the job. This surgery was improved when doctors started using antimetabolites (a type of drug), but this also came with a lot of complications. There’s still a lot of room for improvement in this area.

One of the biggest challenges is trying to control how the eye heals after surgery. Right now, there’s a problem with finding the right balance between successful long-term outcomes and early failures due to scars or issues with the part of the eye that filters fluid (the ‘bleb’).

Other alternatives to trabeculectomy like glaucoma drainage devices or minimally invasive surgeries aren’t a perfect solution either, mainly because their results aren’t reliable and they don’t offer good value for money.

In this article, we’re sharing some of our new ideas for improving glaucoma surgery to make it more effective, safer, and cheaper for patients.

FAQs

  1. What is currently the best treatment for glaucoma?
  2. What are some of the challenges and complications of the current glaucoma surgery, trabeculectomy?
  3. Are there any alternatives to trabeculectomy for glaucoma treatment and if so, why aren’t they considered a perfect solution?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to follow post-operative care instructions carefully. This may include using prescribed eye drops, attending follow-up appointments, and avoiding activities that could put pressure on the eyes. By following these instructions, patients can help ensure the success of their surgery and minimize the risk of complications.

Suitable For

Patients who are typically recommended for glaucoma surgery are those who have not had success with medication alone in managing their condition. These patients may have high eye pressure despite using multiple medications, or they may have significant damage to their optic nerve that is progressing despite treatment. Additionally, patients who are unable to tolerate the side effects of glaucoma medications or who have difficulty adhering to a medication regimen may also be candidates for surgery.

It is important for patients to discuss their individual circumstances with their eye care provider to determine the best course of treatment for their glaucoma.

Timeline

Before the surgery, a patient with glaucoma may have been undergoing treatment with medication or laser therapy to help lower intraocular pressure. If these treatments are not effective, their doctor may recommend surgery.

During the surgery, the patient will be given anesthesia to numb the eye and may receive sedation to help them relax. The surgeon will create a small flap in the eye to allow excess fluid to drain out, reducing pressure on the optic nerve.

After the surgery, the patient will need to follow post-operative care instructions carefully to ensure proper healing. This may include using eye drops to prevent infection and reduce inflammation, as well as attending follow-up appointments with their doctor.

In the weeks and months following surgery, the patient will gradually regain their vision and may experience improved eye pressure control. It is important for the patient to continue monitoring their eye health and attending regular check-ups to ensure the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about glaucoma surgery include:

  1. What is the success rate of trabeculectomy in patients with my specific type of glaucoma?
  2. What are the potential complications or side effects of trabeculectomy surgery?
  3. Are there any alternative surgical options available for treating my glaucoma?
  4. How long is the recovery process after trabeculectomy surgery?
  5. Will I need to continue using glaucoma medications after surgery?
  6. How often will I need to follow up with you after the surgery?
  7. What can I do to help minimize the risk of complications after surgery?
  8. Are there any lifestyle changes I should make to improve the success of the surgery?
  9. What is the cost of the surgery and will my insurance cover it?
  10. Are there any new advancements or technologies in glaucoma surgery that may be beneficial for me?

Reference

Authors: Dada T, Midha N, Shah P, Sidhu T, Angmo D, Sihota R. Journal: Indian J Ophthalmol. 2017 Feb;65(2):103-108. doi: 10.4103/ijo.IJO_865_16. PMID: 28345564