A variety of glaucoma surgeries

Glaucoma accompanied by high intraocular pressure (IOP) probably brings high risks of vision loss, so that early detection and treatment is very important. Due to its high risk of damaging the optic nerve, glaucoma is among the leading causes of blindness. Traditional treatments for this eye disease usually take use of medications which are supposed to control and lower the increased intraocular pressure. Now, surgical treatments are also available. More specifically, both laser and non-laser glaucoma surgeries aim at either decreasing the production of internal eye fluids or increasing the outflow of them. These surgeries can remove the high IOP and stabilize normal IOP, and thus optic nerve is under protection.

Medications are not enough for glaucoma treatment

As mentioned above, surgery is not the only treatment for glaucoma. There are also some medications can suppress the progression of glaucoma, such as topical eye medications and oral medications. Most of these medications can effectively control the IOP level and slow down glaucoma progression. However, some glaucoma patients do need a surgery to improve the drainage of their eye fluids. It is definitely true that a surgical treatment is more thorough and direct. Today, there are several glaucoma surgeries that are proved effective: selective laser trabeculoplasty (SLT), trabeculectomy and other variations.

Laser trabeculoplasty increases the filtration angle

Laser trabeculoplasty is performed by using a laser to create tiny holes in the filtration angle so that the outflow of eye fluids can be increased. In this way, intraocular pressure can be lowered and the severity of glaucoma may be reduced. Moreover, a SLT surgery only brings minimal heat damage to adjacent tissue, which is an adjunct to the patient’s ongoing eye drops. The study of SLT treatment for open-angle glaucoma is on the way.

Trabeculectomy creates new channels for fluids flow

The non-laser surgery trabeculectomy performs in another way. This procedure involves partial removal of the eye’s drainage system. By making a surgical incision into the eye’s drainage system and creating new channels for fluids flow, trabeculectomy surgery can deal with severe glaucoma that is beyond ordinary eye drops, pills and laser trabeculoplasties.

Some details of devices used in trabeculectomy surgery

Trabeculectomy also involves small plastic devices including shunts and implants, whose tiny tubes will be inserted into the holes created in the surgery. Offering a direct passageway, these tubes divert eye fluids to bypass the eye’s damaged drainage channel. These shunts are usually made of silicone or polypropylene. They can be made with or without valves for drainage control. Complications of applying these devices also exist, such as too low IOP, mal-positioned implants and tube erosion. There are also some new types of shunts that are either recently approved or in clinical trials. Reports show that they are safer, even if more complex. Ex-PRESS Mini Glaucoma Shunt and DeepLight Glaucoma Treatment System are two of those types.

Other surgical solutions to glaucoma

Similar variations of trabeculectomy include trabeculotomy without tissue removal and goniotomy for infants and children. Surgeries involve iris treatment include iridotomy and iridectomy. The first type creates a hole in the iris to remove iris blockage and the latter one removes a small piece of iris. By altering the eye’s drainage channels, minimal penetration surgeries can also improve the flow of fluids. These surgeries only create superficial incisions and are less likely to cause complications. Examples of them include a deep sclerectomy that invades the sclera and a viscocanalostomy that involves viscoelastic.

Glaucoma surgery is still in dispute

There are still different opinions about the application of glaucoma surgeries. Some experts argue that glaucoma surgeries are far more expensive than long-term drug treatments. And some others emphasize the downside of these invasive treatments, e.g. complications.