Glaucoma – anti-glaucoma surgeries, treatment

WHAT IS GLAUCOMA?

We explained it here.

WHAT DOES THE DECISION ABOUT THE TYPE OF TREATMENT OF GLAUCOMA DEPEND ON?

On the stage of the disease and its character. If the disease is not yet advanced we start from a pharmacological treatment. In more advanced stages an anti-glaucoma surgery is required.

WHEN IS IT WORTH TO THINK ABOUT AN ANTI-GLAUCOMA SURGERY?

Such decision should be taken when eyes react badly to a pharmacological treatment or in cases when a treatment with eyedrops is impossible for some reason. If necessary, a planned cataract surgery (phacoemulsification) can be combined with a glaucoma treatment.

WHAT DO ANTI-GLAUCOMA SURGERIES AND TREATMENTS ENTAIL?

There are several types of them. An ophthalmic surgeon will choose the most appropriate one.
Trabeculectomy: a surgery aimed at creating an artificial fistula through which aqueous humour can escape from the anterior chamber of the eyeball. This surgery is very effective but unfortunately involves a risk of complications, including cataract – that’s why cataract is often operated together with glaucoma.
Trabulectomy with an ExPress draining implant: an improved version of trabulectomy. During this procedure a surgeon, using a very thin needle, places a microscopic implant made of stainless steel in a patient’s eye. Unfortunately, due to the use of a very precise implant, the cost of this procedure is higher than in case of traditional trabulectomy.
Canaloplasty: the newest, non-invasive method of treating glaucoma. During this procedure a surgeon clears existing tracts of passage of aqueous humour by reinforcing the canal with special prolene threads.
Laser iridectomy: a minimal opening in the iris is made using a very precise laser. This opening improves the exchange between the anterior and the posterior chambers of the eyeball. The surgery very often successfully stops the progress of glaucoma. We need to remember, however, that after such procedure the eye should be regularly assessed by a specialist – the opening is so tiny that it sometimes spontaneously heals and the surgery needs to be repeated.
Surgical iridectomy: very similar to laser iridectomy, as far as its course and results are concerned, but performed surgically. It is recommended to patients with contraindications for the laser procedure.
Cryotherapy of the ciliary body: applying low temperatures to the ciliary body (a part of the eye surrounding the retina). It is used in cases of advanced glaucoma when there is pain and very high intraocular pressure. If cryotherapy is repeated within 3-6 months, the pressure can be stabilized – the patient, however, needs to remain under doctor’s care.
Endoscopic cyclophotocoagulation: an incredibly modern method of reducing the production of aqueous humour. It consists of lasering ciliary processes which produce aqueous humour.