Procedures: Glaucoma Surgery

Glaucoma is the leading cause of preventable blindness in the US. With no symptoms and no pain, millions of people don’t even know they have it. The major known cause of glaucoma is a relative increase in intraocular pressure (IOP). Aqueous fluid is made continuously, and circulates throughout the eye before draining though channels in the eye's anterior chamber. When too much fluid is made, or it is not drained sufficiently, the IOP rises. When many people are finally diagnosed, it is too late to save vision. Your best defense against glaucoma is early detection.

Most glaucoma patients are successfully treated with medicines (eye drops). However, if your glaucoma is still not controlled, you may be a candidate for laser or surgery. There are many different treatments available:

• Trabeculectomy: A small flap is made in the white of the eye. A reservoir is created in the thin clear coating covering the white of the eye. The excess fluid can then drain through the flap into the reservoir. From here, the excess fluid is absorbed into the lymph and blood vessel around the eye. After the reservoir is carefully constructed, the incision is closed with tiny stitches (stitches may later be removed post-operatively to increase drainage).

• Ahmed Valve Tube Shunt: A small, silicone tube connected to a valve is placed in the eye through a tiny incision. The shunt drains excess fluid into a small reservoir on the surface of the eye.

• Laser Trabeculoplasty (ALT) : The argon laser makes tiny evenly spaced burns in the trabecular meshwork. This doesn't provide new drainage holes, but stimulates natural drainage from the eye. ALT has a permanent effect for some patients – for others, the effect may wane after several years.

• Laser Iridotomy: A focused beam of light is used to create a hole on the outer edge of the iris. This hole allows fluid to flow between the front part of the eye and the area behind the iris, decreasing buildup of fluid behind the iris and treating or preventing narrow angle glaucoma.