How is glaucoma treated?
Though there is no cure for most cases of glaucoma, it can be controlled by lowering the intraocular pressure (IOP) to a safe level. Most commonly, eye drops are used to lower IOP. The drops work by either reducing the production of aqueous (fluid in the front chamber of the eye) or increasing drainage of aqueous out of the eye. In some types of glaucoma, a laser procedure may be required initially. When eye drops do not control IOP adequately, glaucoma laser or surgery may be necessary. Treatment and monitoring of glaucoma is continued life-long to ensure that progressive optic nerve damage does not occur. It is extremely important for glaucoma patients to keep taking their eye drops regularly, and to follow-up with the eye doctor as instructed.
What is glaucoma laser?
There are several types of glaucoma laser procedures:
Laser Trabeculoplasty – the trabecular meshwork (the drainage tissue inside the eye) is treated to allow aqueous to drain out of the eye more easily. This is a quick procedure performed in the office.
Laser Iridotomy – an opening is made in the iris to create an alternate pathway for aqueous to circulate. This is used for narrow angle or angle closure glaucoma. This is a quick procedure performed in the office.
Endocyclophotocoagulation (ECP) – the ciliary body tissue (which makes aqueous) is treated to decrease production of aqueous. This is performed in an outpatient surgery center, often combined with cataract surgery.
Transscleral Cyclophotocoagulation (CPC) – Laser energy is applied to the sclera, the outer white wall of the eye, thus altering the cells that form fluid inside the eye. As a result, eye pressure is lowered, glaucoma is controlled, and the need for future medical treatment is reduced. This laser procedure is administered in an outpatient surgery center.
What is glaucoma surgery?
The goal of glaucoma surgery is to improve drainage of aqueous to reduce eye pressure. There are a number of different procedures available, such as trabeculectomy, ExPress mini-tube shunt, Ahmed and Baerveldt tube shunts and canaloplasty. Dr. Wolff and Dr. Westafer have experience with all of these glaucoma procedures. The most common procedure is trabeculectomy, which involves making an opening into the front chamber of the eye to allow aqueous to drain directly out of the eye. A more recent version of trabeculectomy is the ExPress Shunt procedure, which involves using a special tiny tube to drain aqueous from the eye; our Doctors have the most extensive experience with the ExPress Shunt in northern Nevada.
A more recent FDA-approved procedure is canaloplasty. In this procedure, a suture is threaded through Schlemm’s canal (a circular tube that normally drains aqueous fluid from the eye) and tightened, thereby distending Schlemm’s canal to allow increased drainage of aqueous fluid out of the eye, resulting in reduced eye pressure. A significant advantage of this procedure is that it reduces the serious risks and complications that are seen with other glaucoma procedures.
WHAT IS MICRO INCISIONAL GLAUCOMA SURGERY?
MIGS is a group of surgeries that are designed to lower eye pressure for individuals who have glaucoma, all with fewer possible complications. Traditional glaucoma surgeries, such as a trabeculectomy or external tube shunts, can lead to complications such as discomfort, abnormally low eye pressure, and eye infections. Learn more.