26th Jan, 2019

Surgical procedures for treating glaucoma

San Diego glaucoma treatment

Surgical procedures for treating glaucoma

Glaucoma is a disease of increased pressure within the eye. Over time, this increased pressure can lead to vision loss by damaging to the optic nerve, which is the nerve that communicates information from the eye to the brain. The increased pressure is caused by a buildup of a fluid known as aqueous humor within the eye. This fluid is constantly produced within the eye, and is normally able to drain out of the eye through an area known as the trabecular meshwork. (Note that aqueous humor is not the same as lacrimal fluid, or tears. Tears remain on the outside of the eye, while aqueous humor is produced inside and then drains out.)

The key to saving the vision of a person with glaucoma is to keep the intraocular pressure under control. For most patients, this can be accomplished with eye drops. However, there are some patients for whom eye drops are not enough to keep the eye low and prevent damage to the optic nerve. For these patients, there are several different surgical procedures available that may help to save their sight.

Trabeculectomy or trabeculotomy

These methods use surgical instruments to open the trabecular meshwork. This provides space for fluid to drain more easily out of the eye, which helps to lower eye pressure. In a trabeculectomy, a small piece of tissue is removed from this area, leaving more space for fluid to flow through. In a trabeculotomy, small holes are created, but tissue is not removed.

Iridectomy

The iris is the colored part of the eye. In an iridectomy, a tiny piece of the iris is surgically removed in order to allow drainage of fluid from the eye. This treatment is effective for a type of glaucoma known as narrow-angle glaucoma, in which the iris bows forward and impedes the drainage of fluid from the eye. (This form of glaucoma can also be known as angle-closure or closed-angle glaucoma.) Although it is possible to see the tiny hole in the iris if one looks very closely, it generally doesn’t have a significant impact on one’s appearance.

Shunts and stents

Both of these methods use a small device to maintain an opening through which aqueous humor can flow. The difference between a shunt and a stent is that a shunt creates a new opening that would not normally exist, while a stent holds open a normal anatomical opening.

In glaucoma surgery, a shunt is used to allow excess fluid to drain from the eye into a space beneath the conjunctiva, which is the white part of the eye. This creates a small bubble under the conjunctiva, which is generally hidden under the upper eyelid so that it cannot be seen most of the time. For most patients, this bubble (which is referred to as the bleb) doesn’t cause any discomfort, although some patients may be bothered by the bleb.

A stent is used to hold open the trabecular meshwork, to improve the flow of fluid through it. This helps to improve the drainage of aqueous humor through its normal channels.

Laser procedures for glaucoma

The development of more powerful and precise lasers has revolutionized many areas of medicine, and ophthalmology is no exception. Lasers can be used in a few different ways to improve the drainage of fluid from the eye, including for trabeculoplasty or iridotomy.

In a trabeculoplasty, the laser is used to open the trabecular meshwork. This is similar to a trabeculotomy, but is accomplished with the use of lasers instead of using sharp surgical instruments. In an iridotomy, a small hole is opened at the edge of the iris, which is the colored part of the eye, in order to allow fluid to drain out.

San Diego glaucoma treatment

Patients with glaucoma in the San Diego area are invited to schedule an appointment with the experts at California Retina Associates to discuss their treatment options. If treatment with eye drops hasn’t worked for your glaucoma, then you may benefit from surgery. Different procedures recommended for different patients, depending on many factors. Our San Diego glaucoma treatment patients receive our expert recommendations and advice regarding their treatment options.

Posted on January 26, 2019 By , in

Related Articles

Dr. P.