Glaucoma Surgery

Glaucoma surgery aims to lower intraocular pressure (IOP) and prevent vision loss caused by optic nerve damage. As the second leading cause of blindness worldwide, glaucoma requires timely intervention when medications/lasers fail to control progression.

Types

• Open-Angle Glaucoma (Most common, slow progression)
• Angle-Closure Glaucoma (Medical emergency)
• Congenital Glaucoma (Pediatric cases)
• Secondary Glaucoma (Post-trauma/inflammation)

Surgical Options for Glaucoma

1. Laser Procedures (Minimally Invasive)

• Selective Laser Trabeculoplasty (SLT) – Enhances drainage
• Laser Peripheral Iridotomy (LPI) – For angle-closure
• Cyclophotocoagulation – Reduces fluid production

2. Traditional Surgeries

• Trabeculectomy (Gold standard) – Creates new drainage
• Glaucoma Drainage Implants (Ahmed/BAERVALV® shunts)
• Minimally Invasive Glaucoma Surgery (MIGS)
  • iStent® – Micro-bypass stent
  • XEN Gel Stent – Subconjunctival drainage

Who Needs Surgery?

⚠ Indications:

• Uncontrolled IOP despite maximal meds
• Rapid visual field loss
• Intolerance to eye drops

Procedure & Recovery

• Duration: 15-60 mins (varies by technique)
• Anesthesia: Local (with sedation if needed)
• Recovery Timeline:
  • 1-2 weeks for laser procedures
  • 4-6 weeks for trabeculectomy/MIGS

Advances in Glaucoma Surgery

• Micro-Incisional Techniques – Faster healing
• ABiC™ (Canaloplasty) – Non-penetrating
• AI-Powered IOP Monitors – Post-op tracking

Risks vs. Benefits

Pros:

• Prevents blindness in 90%+ compliant patients
• Reduces medication dependence
  Cons:
• Infection/bleeding risks (<5% cases)
• May need repeat procedures