GLAUCOMA SURGERY

Your doctor has decided that surgery offers a benefit for the treatment of your glaucoma because the other treatments that you have had (drops or laser) have not been sufficient to lower the eye pressure to a safe level for your eye. If the pressure is not lowered further it is anticipated there will be further damage to the optic nerve and further loss of visual field.

Aims of Surgery

The aim of the surgery is to decrease the pressure in the eye to a level that is safe for the optic nerve so that the slow progressive loss of vision caused by glaucoma is arrested.

So the aim of glaucoma surgery is to preserve the amount of vision you have, not to improve the vision (in fact vision is never improved with glaucoma surgery). In some 20% of cases there can be a slight decrease in vision post operatively - usually temporary. However, any tendency to cataract formation may be accelerated by glaucoma surgery. And this can make the vision permanently worse unless cataract surgery is performed.

What Happens in Glaucoma Surgery?

Glaucoma surgery involves creating a small valve in the eye which allows some of the eye's fluid to leak out in a controlled manner. The body may try to heal this leak, and medications are used to control the body's healing response.

Risks of Glaucoma Surgery

The risks of surgery are similar to other intraocular operations and are infrequent. Major risks include:
· haemorrhage at the time of surgery which can be vision- or eye-threatening,
· infection - either soon after surgery or as a delayed effect,
· swelling or detachment of the retina.All of these are very rare following glaucoma surgery, but have occurred, even in the most skilfully performed surgery.

The other risks are those associated with the anaesthetic such as risks of either general anaesthetic complications or complications associated with the local anaesthetic which requires an injection around the eyeball.

All the risks referred to above all add up to a risk of less than 1% of making you permanently much worse with the surgery.

How is the Surgery Performed?

Usually glaucoma surgery can be performed under local anaesthesia as a day patient procedure. General anaesthesia can also be used. You may need to see the surgeon on each of the first few days following surgery and then at increasing intervals until everything settles down. You may or may not need your former glaucoma drops after your surgery. After the surgery any evidence of inflammation or infection around the eye should be urgently reported to your treating ophthalmologist.