Our Summary

This research paper is about the treatment options for glaucoma, a common cause of blindness that affects about 1.4% of Germans aged between 35 and 74. At present, the only proven way to treat this condition is by reducing the pressure inside the eye.

Traditional surgery for this condition, known as a trabeculectomy, can cause complications in 3-15% of cases. Because of this, doctors are now using minimally invasive procedures that involve implanting tiny stents into the eye to reduce the pressure. These procedures are safer, but they’re only suitable for people with mild to moderate glaucoma.

Three of these procedures – the Kahook Dual Blade, iStent inject, and Hydrus Microshunt – have been tested in clinical trials. Out of these, only the iStent inject and the Hydrus Microshunt procedures have been proven to reduce eye pressure more than cataract surgery alone. They can also slow down the loss of vision. However, more research is needed to test the effectiveness of other procedures.

FAQs

  1. What are some of the current treatment options for glaucoma?
  2. What are the potential complications of traditional glaucoma surgery?
  3. What are some of the minimally invasive procedures being used for glaucoma treatment and how effective are they?

Doctor’s Tip

A doctor might tell a patient undergoing glaucoma surgery to follow all post-operative instructions carefully, including using any prescribed eye drops as directed, attending follow-up appointments, and avoiding strenuous activities that could increase eye pressure. It is important to report any unusual symptoms or changes in vision to your doctor immediately. Following these guidelines can help ensure the best possible outcome after glaucoma surgery.

Suitable For

Patients who are typically recommended glaucoma surgery are those with mild to moderate glaucoma who have not responded well to other treatments such as eye drops or laser therapy. These patients may experience increased eye pressure, progressive vision loss, or worsening of their condition despite treatment.

Additionally, patients who are unable to adhere to a strict regimen of eye drops or who experience significant side effects from their medication may also be candidates for glaucoma surgery. It is important for patients to discuss their treatment options with their ophthalmologist to determine the best course of action for their specific situation.

Timeline

Before the glaucoma surgery, the patient will typically undergo a series of tests to assess the severity of their condition and determine the most appropriate treatment plan. This may include visual field tests, optic nerve imaging, and measuring the intraocular pressure.

During the surgery, the patient will be given anesthesia to ensure they are comfortable and pain-free. The surgeon will then perform the procedure, which may involve creating a small incision in the eye, implanting a stent, or using a laser to reduce eye pressure.

After the surgery, the patient will be monitored closely for any complications or side effects. They may need to use eye drops or other medications to help with healing and reduce inflammation. Follow-up appointments will be scheduled to assess the effectiveness of the surgery and make any necessary adjustments to the treatment plan.

Overall, the goal of glaucoma surgery is to prevent further damage to the optic nerve and preserve the patient’s vision. While the recovery process can vary depending on the individual and the type of surgery performed, most patients experience improved eye pressure and vision over time with proper care and monitoring.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with glaucoma surgery?
  2. How long is the recovery period after glaucoma surgery?
  3. Will I need to continue using eye drops or other medications after the surgery?
  4. How often will I need to follow-up with my doctor after the surgery?
  5. Are there any lifestyle changes I should make to improve the success of the surgery?
  6. How will the surgery affect my vision and quality of life in the long term?
  7. Are there alternative treatment options for my specific type of glaucoma?
  8. How experienced are you in performing minimally invasive glaucoma surgeries?
  9. What is the success rate of the specific procedure you are recommending for me?
  10. Can you provide me with any resources or additional information about glaucoma and its treatment options?

Reference

Authors: Voykov B, Prokosch V, Lübke J. Journal: Dtsch Arztebl Int. 2025 Jan 10;122(1):23-30. doi: 10.3238/arztebl.m2024.0240. PMID: 39670502