Surgery reduces the pressure in the eyes by opening blocked
drainage angles or creating a new opening that fluid can
flow through to leave the eye. In some cases surgery may be done to relieve pain caused by
Medicine will usually
be tried before surgery is considered.
Doctors can use
either a surgical cutting tool or a very focused beam of light, called a laser,
to do surgery for glaucoma.
Laser surgery is usually the first type of surgery tried. If laser surgery doesn't help, your doctor may try
It is not
unusual for some people to have both open- and closed-angle glaucoma. They may need more than one kind of procedure.
Surgery choices for adults
There are three basic types of surgery for glaucoma in
Surgery to increase drainage of fluid from the eye
This type of surgery involves making a trapdoor that allows fluid to
drain from the eye.
involves an incision to remove a piece of tissue to allow fluid to drain from the
- Tube-shunt surgery (seton glaucoma surgery) involves an incision to place a
tube in the eye to allow fluid to drain.
- Laser trabeculoplasty burns tissue to create an
opening that allows fluid to drain from the eye.
- Laser sclerostomy removes a piece of the white part of the eye to allow fluid
to drain. This type of surgery is rarely done.
Surgery to prevent closure of the drainage angle
These procedures involve making a new opening in the
colored part of the eye (iris) that allows fluid to flow through the eye. They
are used to treat sudden (acute) and long-term closed-angle glaucoma. The procedures also will prevent
closed-angle glaucoma in people who have narrow drainage angles.
- Surgical iridectomy uses a surgical cutting tool.
- Laser iridotomy
uses a laser.
iridotomy can usually be done instead of surgical iridectomy. But some people
with complicated or severe glaucoma may need to have surgical iridotomy.
Surgery to decrease the amount of fluid produced in the eye
When other surgery fails to improve the flow of fluid from
the eye, procedures to destroy the part of the eye that produces fluid (ciliary
body) can be done. These procedures are also used when scar tissue has formed
after a previous surgery.
Surgery choices for children
glaucoma, there are two slightly different procedures that both attempt to open
the drainage angle directly. They are equally successful in children, but they
are not used for adults. If these procedures fail in a child, then
trabeculectomy or tube-shunt surgery may be tried.
Deciding about surgery
Deciding whether to have surgery is difficult because:
- You may not be in pain or notice any vision loss.
- Your vision may get worse right after surgery and may be affected for weeks or months. Your eyesight may not be as good as it was before the surgery.
- Surgery isn't a complete cure for
glaucoma. But surgery can decrease the chance of losing even more eyesight
later on. And for some people, it can reduce or get rid of the need for eyedrops.
- Not everyone who has laser surgery will have lower
IOP after the surgery. For most people, the lower pressure
will last only a few years. Others may have an increase in their eye pressure.
Certain types of open-angle glaucoma respond better to laser surgery than
- The effects of some laser treatments aren't long-lasting.
Repeat laser treatments, medicines, or other surgeries may be needed later
As with any other surgery, you and your doctor should
make the decision to operate based on the risks and benefits of having the
surgery. One thing to consider is
which eye should be operated on first. There may be other
questions about glaucoma surgery that you should
discuss with your doctor before making a decision.
Cataracts may occur in people who also have glaucoma. This commonly occurs in older people. Surgery to remove the cataract may be
done at the same time as surgery for glaucoma. If
surgeries for glaucoma and a cataract are done at the
same time, you may notice improved eyesight after surgery.