Glaucoma Surgery: Is It Right for Me?

Should I Get Glaucoma Surgery?

Glaucoma affects approximately three million Americans every year. Defined as a series of eye diseases that can damage the optic nerve, a bundle of nerve fibers that sends information to the brain, causing vision loss and blindness, glaucoma often presents without outright symptoms in its early stages, and may require surgery by the time it gets to moderate or advanced stages. Glaucoma can occur at any point in life, so it’s important to schedule regular eye exams to assess your risk for the condition. Learn about the different types of glaucoma surgery and whether or not it’s right for you or your loved one.

Types of Glaucoma Surgery

Glaucoma Surgery
(This image is from Pixabay.)

The most common glaucoma operations include:

  • Trabeculectomy – Surgical removal of part of the eye’s drainage system for better flow.
  • Tube Shunt – Drainage device implantation to redirect flow from the obstruction.
  • Cyclophotocoagulation – Laser surgery to relieve intraocular eye pressure (IOP).

Risks of Glaucoma Surgery

Though the risks of glaucoma surgery are few, and their occurrence rare, the following possibilities should be discussed with your doctor before any type of glaucoma surgery.

  • Vision loss: Expect some temporary vision loss immediately after surgery as your eyes are healing. Permanent vision loss is a risk of any eye surgery, but it is extremely rare.
  • Bleeding in the eye: Internal bleeding in the eye can be a serious complication that threatens your long-term vision. Let your ophthalmologist know if you are on blood thinners, as you may need to discontinue use before surgery.
  • Infection: Despite the application of antibiotics and best efforts to maintain a sterile environment, an infection can sometimes occur weeks, months, or years following surgery. Contact your doctor immediately if you experience post-surgery redness, pain, or excessive tearing. Most infections can be treated with antibiotic drops if caught early.
  • Low eye pressure (hypotony): Glaucoma surgery can sometimes provoke temporary low IOP, which may cause you to see shadows in your peripheral vision.
  • Scarring: Scar tissue may form during the healing process, which can cause IOP to increase and negate the benefits of surgery. If this occurs, you may need to restart your glaucoma medications or undergo an additional operation.
  • Cataracts: Glaucoma surgery can accelerate cataract formation. In some cases, the two surgeries may be combined for people with both diseases.

New Advancements in Glaucoma Surgery

A group of newer procedures called minimally-invasive glaucoma surgery (MIGS), are increasingly growing in popularity. Frequently, a MIGS is combined with cataract surgery to lower eye pressure in patients with early- to moderate-stage glaucoma.

MIGS involves limited manipulation of the sclera (thick white wall of the eye) and conjunctiva (transparent outermost layer)—making it safer than traditional glaucoma surgeries. The improved safety features, however, often yield more modest results. Thus, MIGS may not achieve the intended reduction in eye pressure for patients with more advanced glaucoma.

When Should I Consider Glaucoma Surgery?

Your doctor may recommend surgery if you receive a late or advanced diagnosis and if medicines or laser treatments haven’t worked. It’s important to realize that surgery will not reverse vision loss or counteract the effects of glaucoma, but it will help to prevent further visual impairment. For more information on the pros, cons, side effects, and benefits of glaucoma surgery, download the Responsum for Glaucoma app.