Glaucoma Surgery Treatment and Procedures

Advanced surgical care to lower eye pressure

Explore the various types of Glaucoma Surgery available at Liv Hospital. From laser treatments to microscopic implants, learn how we protect your vision.

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Treatment and Procedures

Navigating Your Surgical Options

What types of glaucoma surgery are there ? This is a common question for patients who are moving beyond eye drop therapy. The selection of a procedure depends on the specific type of glaucoma, the target pressure required, and the patient’s overall health history. At Liv Hospital, we offer a full spectrum of interventions, ranging from office based laser treatments to complex operating room surgeries. Each procedure is designed to create a reliable and sustainable way for fluid to exit the eye, thereby protecting the optic nerve from further pressure damage.

Glaucoma Laser Surgery: Minimally Invasive Relief

Glaucoma laser surgery is often the first surgical step considered when medications are insufficient. It is a minimally invasive procedure usually performed in the clinic setting.

Selective Laser Trabeculoplasty (SLT): Uses low energy light to stimulate the eye’s natural drainage cells.
Laser Peripheral Iridotomy (LPI): Creates a tiny hole in the iris to prevent acute pressure spikes in narrow angles.
Laser Cyclophotocoagulation: Targets the fluid producing tissue to lower the overall volume of fluid in the eye.

These procedures are quick, typically taking less than 15 minutes, and involve minimal discomfort with a very fast return to daily activities.

Trabeculectomy: The Filtration Gold Standard

Trabeculectomy is a traditional filtration surgery that remains a gold standard for achieving very low eye pressure in advanced cases.

During this procedure, the surgeon creates a small, guarded “door” or flap in the white part of the eye (sclera). This allows fluid to bypass the clogged natural drain and flow into a small reservoir, called a bleb, tucked under the upper eyelid.

From the bleb, the fluid is naturally absorbed back into the body’s circulation. This surgery is highly effective for patients who need a significant, permanent reduction in their intraocular pressure to save their remaining vision.

Drainage Implant and Shunt Surgery

Drainage implant surgery involves the placement of a small silicone tube into the front chamber of the eye. This tube is attached to a small, thin plate that is tucked safely under the surface tissues of the eye.

Tube Shunts (Ahmed or Baerveldt): These act like a permanent plumbing bypass.
Ideal for patients with previous failed surgeries or complex forms of the disease.
Provides a consistent path for fluid to exit even when the natural meshwork is completely scarred.
The device is not visible to others and is designed to last a lifetime.

Implants are often the preferred choice for patients with secondary glaucoma or those who have had extensive trauma to the eye.

Minimally Invasive Glaucoma Surgery (MIGS)

Minimally Invasive Glaucoma Surgery (MIGS) is a newer category of procedures that utilize microscopic equipment and tiny incisions. These procedures have become very popular because they offer a high level of safety and a faster recovery compared to traditional surgeries.

Micro-Stents (iStent or Hydrus): Tiny devices inserted into the natural drain to keep it open.
Canaloplasty: Using a micro-catheter to enlarge the eye’s natural drainage canal.
Xen Gel Stent: A microscopic tube that creates a soft path for fluid to leave the eye.

MIGS procedures are often performed at the same time as cataract surgery, allowing us to treat both conditions simultaneously.

Cyclophotocoagulation (CPC) Techniques

Cyclophotocoagulation (CPC) is a procedure that targets the ciliary body, which is the part of the eye responsible for producing aqueous humor. Instead of focusing on improving drainage, this surgery focuses on reducing the “inflow” of fluid.

Endoscopic CPC (ECPC): Performed from inside the eye, often during cataract surgery.
Micropulse CPC: A gentler laser approach that reduces fluid production with less inflammation.
Often used for patients who have limited vision but need pressure control to prevent pain.

By lowering the production of fluid at the source, we can achieve effective pressure control in eyes that are not suitable for traditional drainage surgeries.

The Surgical Experience At Liv Hospital

The surgical procedure itself is a highly coordinated effort. Most patients are given a mild sedative to help them relax, and the eye is thoroughly numbed using local anesthesia or specialized drops. You will be awake but comfortable and will not feel any sharp pain. The surgeon uses microscopic instruments and a high definition surgical microscope to perform the delicate work within the eye. Throughout the process, the surgical team monitors your comfort and the stability of the eye to ensure an efficient and safe experience.

Measuring Success and Stability

Success in these procedures is measured by the stability of the eye pressure and the lack of progression in the visual field. While no surgery can restore vision, the advanced techniques at Liv Hospital result in very high success rates for stabilizing the disease.

A significant reduction in the dependence on daily eye drops.
A stable visual field map over several years of follow up.
The absence of emergency pressure spikes that could cause rapid blindness.
Long term preservation of the patient’s quality of life and independence.

Our specialists work closely with you to define target goals and ensure the surgery meets your specific needs.

Choosing The Right Surgical Specialist

Glaucoma surgery requires a high level of specialized training and microscopic precision. It is important to choose a fellowship trained glaucoma specialist who understands the nuances of the eye’s drainage system. A specialist is prepared to handle the unique healing responses of different patients and can adjust the treatment plan as the eye heals. At Liv Hospital, our surgical team is dedicated exclusively to the management of complex pressure disorders, providing a level of expertise that ensures the best possible care for your eyes.

The Decision Making Process

The decision to proceed with surgery is a collaborative one made between you and your doctor. We take the time to explain the pros and cons of each option, the potential risks, and the expected recovery timeline.

Balancing the risk of the procedure against the risk of permanent vision loss.
Considering your lifestyle and your ability to manage the post operative drop schedule.
Assessing the urgency of the pressure reduction based on your test results.
Reviewing your previous eye health history to choose the most compatible technique.

Our goal is to ensure you feel confident and fully informed as you take this vital step toward protecting your sight.

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FREQUENTLY ASKED QUESTIONS

How long do I have to stay in the hospital after surgery?

Most glaucoma surgeries are outpatient, meaning you will go home about an hour or two after the procedure is finished.

Is it possible for the surgery to fail over time?

The eye’s natural healing process can sometimes try to close the new drain, but this can often be managed with medications or minor office adjustments.

Can I have both eyes operated on at once?

Usually, we wait at least a few days to a few weeks between eyes to ensure the first one is healing properly and safely.

Will my eyes look different after surgery?

For most procedures, there is no visible difference. In filtration surgery, there might be a small, hidden bump under the upper eyelid.

Does laser surgery have to be repeated?

Some laser treatments, like SLT, can be repeated if the effect wears off after a few years, while others are more permanent.