GLAUCOMA SURGERY

GLAUCOMA SURGERY

Glaucoma surgery is done to reduce the pressure within the eye. The surgery is performed either through laser treatment or by making a cut (incision) in the eye. The type of surgery will depend on the type of glaucoma that the patient has and whether it has responded to the use of medicine.

Before glaucoma surgery, tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.

Generally, this is a safe procedure. However, problems may occur, including:

  • Blurry vision.
  • Increase or decrease in eye pressures.
  • Sensitivity to light.
  • Clouding of your lens (cataracts).
  • Infection or scarring of your eye.
  • Bleeding into your eye.
  • Loss of vision (rare).

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking restrictions, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

General instructions

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines before your procedure if your health care provider instructs you not to.
  • Plan to have someone to take you home from the hospital or clinic.
  • You may have blood tests. These tests can help show how well your kidneys and liver are working. They can also show how well your blood clots.
  • To reduce your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
    • Hair may be removed from the surgical area.
  • An IV tube will be inserted into one of your veins. Medicine will flow directly into your body through this tube. You may be given medicine to help prevent nausea and pain and antibiotic medicine to help prevent infection.
  • Your eye will be numbed with eye drops.
  • Your eye surgeon will use one of the following procedures to treat your condition:
    • Laser iridotomy. This procedure uses a laser to burn a small hole in the colored part of the eye (iris). It is used to treat the kind of glaucoma in which fluid builds up behind the iris (angle-closure glaucoma).
    • Laser iridectomy. This is a procedure in which a small piece of the iris is cut away to allow fluid or pressure to be released. It is used to treat a type of glaucoma in which pressure builds in the eye because internal drainage is blocked (narrow-angle glaucoma).
    • Selective laser trabeculoplasty. In this procedure, a laser is used to enlarge the drainage openings near the base of the iris (filtration angle). It is used to treat a type of glaucoma in which pressure slowly builds in the eye, with symptoms coming at a later stage of the disease (open-angle glaucoma).
    • Filtering surgery (also called incisional surgery). In this procedure, a small button of the white outer coat of your eyeball (sclera) is removed. This allows the fluid to seep under the membrane that covers the inside of the eyelid (conjunctiva), thus lowering eye pressure. The most common type of filtering procedure is a trabeculectomy.
    • Cyclodestructive procedures. This is a procedure that uses a laser or freezing tool to destroy the part of the eye that produces fluid (ciliary body). This reduces pressure by reducing the fluid that the eye produces. It is done in cases where glaucoma has not responded to medicines or other surgical procedures.
  • The procedure may vary among health care providers and hospitals.
  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • You may receive medicines for discomfort.
  • You may lose part or all of your vision for a while.
  • You will go home with eye drops and an eye patch to protect your eye.
  • There will be changes in your ability to see the distance of objects (depth perception).
  • It will be hard to walk the stairs.
  • You will not be able to drive.
  • Glaucoma surgery is done on an outpatient basis. The surgeon may need to examine the eye and measure the pressure later on the same day of the surgery or the following day.

Summary of glaucoma surgery:

  • Glaucoma surgery is done to reduce the pressure within the eye.
  • Common surgical procedures used to treat glaucoma include: laser iridotomy, laser iridectomy, selective laser trabeculoplasty, filtering (or incisional) surgery, and cyclodestructive procedures.
  • Generally, this is a safe procedure.
  • Plan to have someone take you home from the hospital or clinic.

 

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