Our Summary

Glaucoma, a leading cause of blindness in Europe, is typically treated by reducing the pressure inside the eye. It’s important that the treatment is not only effective but also well-tolerated by the patient and cost-effective. There are four main types of medication used in treatment: beta blockers, prostaglandins, alpha-2 agonists, and carbonic anhydrase inhibitors.

In some cases, laser surgeries like Laser Peripheral Iridotomy (LPI), Laser Iridoplasty, or Selective Laser Trabeculoplasty can be used. These procedures aim to improve the flow of fluid in the eye, thereby reducing the pressure. If the pressure continues to increase despite medication or laser treatments, more invasive surgical procedures may be required.

These traditional surgeries, such as Deep Sclerectomy or Trabeculectomy, are known to be effective but can sometimes lead to complications. As a result, less invasive procedures, known as MIGS (mini invasive glaucoma surgery), are being developed. For tough cases of glaucoma, non-invasive procedures like High-intensity Focused Ultrasound, which uses sound waves to treat the eye, are being used to reduce the long term complications associated with more traditional treatments.

FAQs

  1. What are the main types of medication used in glaucoma treatment?
  2. What are the different types of surgery available for glaucoma treatment?
  3. What is MIGS and how does it help in the treatment of glaucoma?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to follow all post-operative instructions carefully, including using any prescribed eye drops or medications as directed, attending follow-up appointments, and avoiding activities that could increase eye pressure such as heavy lifting or straining. It’s also important to report any unusual symptoms or changes in vision to your doctor promptly. By following these guidelines, patients can help ensure the success of their glaucoma surgery and maintain good eye health in the long term.

Suitable For

Typically, patients who are recommended for glaucoma surgery are those who have not responded well to medication or laser treatments, and whose eye pressure continues to increase. Patients with severe or advanced glaucoma, or those at risk of vision loss despite treatment, may also be recommended for surgery. Additionally, patients who are unable to tolerate glaucoma medications or who have contraindications to certain medications may also be candidates for surgery. Ultimately, the decision to undergo glaucoma surgery should be made in consultation with an ophthalmologist who can assess the individual patient’s specific needs and risks.

Timeline

Before glaucoma surgery:

  • Patient is diagnosed with glaucoma through regular eye exams and tests to measure eye pressure.
  • Patient may be prescribed medication to reduce eye pressure and prevent further damage to the optic nerve.
  • If medication is not effective, patient may undergo laser surgery to improve fluid drainage in the eye.
  • If pressure continues to increase, patient may require more invasive surgical procedures such as Trabeculectomy.

After glaucoma surgery:

  • Patient may experience temporary discomfort, redness, and blurred vision immediately after surgery.
  • Patient will need to follow post-operative care instructions, including using eye drops and avoiding strenuous activity.
  • Patient will have follow-up appointments to monitor eye pressure and ensure the surgery was successful.
  • In some cases, additional surgeries or treatments may be necessary if the pressure in the eye continues to increase.
  • Patient will continue to have regular eye exams to monitor for any changes in vision and to prevent further damage from glaucoma.

What to Ask Your Doctor

  1. What are the risks and benefits of glaucoma surgery compared to continuing with medication or laser treatments?

  2. What type of glaucoma surgery is recommended for my specific case and why?

  3. What is the success rate of the recommended surgery and how long will the effects last?

  4. What are the potential complications or side effects of the surgery and how likely are they to occur?

  5. Will I need to take any additional medications or follow-up treatments after the surgery?

  6. How long is the recovery process and what restrictions or limitations will I have during this time?

  7. What is the cost of the surgery and will my insurance cover it?

  8. Are there any alternative treatments or procedures that I should consider before opting for surgery?

  9. How often will I need follow-up appointments after the surgery and what signs or symptoms should I watch for that may indicate a complication?

  10. Can you provide me with any resources or information to help me better understand the surgery and what to expect?

Reference

Authors: Bluwol E. Journal: Rev Prat. 2016 May;66(5):508-513. PMID: 30512573