Glaucoma is the term describing a group of eye diseases associated with damage to the optic nerve, which is the nerve that connects your eye to your brain and transmits signals back and forth.
Glaucoma is the leading cause of irreversible blindness and often appears without warning, with no symptoms. When symptoms of glaucoma manifest, it’s often too late, and vision loss has already begun.
Management is a step by step process, usually starting with drops, but treatment would include or progress to laser and surgery. Your ophthalmologist will discuss the best option for you.
THE TRABECULECTOMY PROCEDURE
Trabeculectomy is a surgical procedure that reduces the intraocular pressure (IOP) that exists inside of your eye if you have glaucoma. Trabeculectomy is performed by cutting a small hole in the sclera (the wall of your eye) and covering the opening with a thin flap that acts as a trap door. This allows the liquid (called the aqueous humour) to drain from your eye. It drains into a bleb or small reservoir just under the eye’s surface that’s obscured by your eyelid.
The trap door is stitched in such a way so that it prevents the fluid from draining too rapidly. By draining the fluids in your eye, the surgery is effective in reducing pressure on your optic nerve. The procedure also slows down or prevents further damage and loss of vision.
LASER SURGERY FOR GLAUCOMA
Laser surgeries have become increasingly effective and popular in treating various types of eye problems and diseases, including glaucoma. There are several types of laser surgery to treat glaucoma, depending on your form of glaucoma and its severity. Laser surgeries are outpatient procedures.
Laser surgery works by focusing a beam of light that burns a small opening in your eye tissue or causing alterations in the physiology of your eye tissue. The strength of the beam can be varied to cut through thicker tissues. The most common types of glaucoma laser surgical procedures include:
- Argon Laser Trabeculoplasty (ALT): ALT treats primary open-angle glaucoma (POAG). POAG is the most common form of glaucoma, present in 1% of all adults over the age of 50, according to The Glaucoma Foundation. It’s referred to as the “silent thief of sight” as it appears without warning. The ALT laser treatment opens the fluid channels of your eye, helping it drain better. This procedure typically is supported by other medication treatments. In most cases, only half the channels are treated; your other fluid channels can be treated in a separate session. This prevents over-correction and decreases the risk of eye pressure building up after the surgery.
- Selective Laser Trabeculoplasty (SLT): SLT also treats POAG. SLT works by treating “selective” cells with low levels of energy (a weaker laser). It leaves untreated areas intact and thus can be safely repeated if necessary. SLT is often an alternative for patients who have been treated unsuccessfully with eye pressure-lowering drops or an ALT laser treatment.
- Laser Peripheral Iridotomy (LPI): LPI treats narrow-angle glaucoma or angle-closure glaucoma. This type of glaucoma occurs when the angle between your cornea and iris is too small, which causes your iris to block fluid drainage naturally, increasing the pressure in your eye. LPI cuts (or burns) a small hole in your iris, allowing fluid to drain from the new hole.
- Laser Cyclophotocoagulation (CP): This is an alternative to filtering microsurgery typically used later in the treatment process. In this procedure, several different types of lasers are used to inhibit your eye’s ability to make fluid (which occurs in the ciliary), and thus lowers the pressure in your eye. The procedure is also used to prevent glaucoma and may require repeated treatments to control glaucoma permanently.
The LPI and ALT forms of glaucoma surgery produce a slight stinging sensation. A local anaesthetic is applied to the eye for SLT and CP laser surgery to numb the eye. Once numbed, you shouldn’t feel any discomfort or pain.
Benefits of Glaucoma Laser Surgery
Glaucoma laser surgeries work to lower intraocular pressure in your eyeball. Many factors determine the length of time your IOP remains lowered. These factors include the type of surgery, type of glaucoma, age, race and other factors. Some people may have to repeat surgical procedures to control their IOP.
The recovery time for glaucoma laser surgery is very brief. Typically, you can resume normal daily activities as early as the day after laser surgery. You may experience blurry vision and irritation right after the surgery, so you should arrange a ride home after the procedure.