Conventional Glaucoma Surgery
Advanced filtering microsurgery relieves damaging pressure.
In a trabeculectomy, part of the trabeculum is removed to alleviate intraocular pressure. In a sclerostomy, a micro drainage hole is created in the sclera, allowing fluid to drain. Your ophthalmologist will know if either of these surgeries, or another, is best for you. Typically, the goal of conventional glaucoma surgery is to create an alternative means for intraocular fluid to bypass the clogged drainage canals. The surgeries have high efficacy rates, and in cases where blockages reappear the surgery can be repeated.
Conventional glaucoma surgery is typically the course when medication and laser surgery are not sufficient to manage eye pressure. Other factors can also apply. Your Edina Eye physician will help you determine what makes the best sense for your condition.
What You Can Expect Prior to Surgery
If your doctor determines you require filtering microsurgery, you’ll set an appointment to meet your surgeon for a comprehensive eye exam and evaluation of your specific situation. At this consultation your surgeon will advise you when to begin each of the following steps:
- Take fish oil supplements to decrease dry eye symptoms
- Insert artificial tears (liquid drops) four times per day
- Stop wearing contact lenses
What You Can Expect During Surgery
You’ll be asked to arrive 45 minutes prior to surgery to sign various forms and receive post-operative instructions. At this time you will also meet again with your surgeon to answer any questions. Please note you can’t drive after surgery, so please make arrangements to have someone take care of your transportation. In most cases, there is no pain involved. The surgery is usually done with a local anesthetic and relaxing medications. Often a limited type of anesthesia, called intravenous (I.V.) sedation, is used.
In addition, an injection is given around or behind the eye to prevent eye movement. This injection is not painful when I.V. sedation is used first. As a patient, you will be relaxed and drowsy and will not experience any pain during surgery.
- You will take a Valium to relax and settle back into a near-horizontal position in your surgical chair
- A special pillow keeps your head comfortable and still
- Anesthetic drops are applied to numb your eyes; additional drops are used throughout the procedure
- Your surgeon will place a special ring that gently applies pressure to flatten your cornea and hold the eye still
- This pressure, or suction, may be uncomfortable and darken your vision; this is normal, but is only temporary
- A lid speculum is placed into the eye to prevent blinking
- If you are having a sclerostomy, an instrument is used to create an opening in the sclera, creating a drainage pathway for fluid out of the eye
- If you are having a trabeculectomy, an instrument is used to remove part of the trabeculum, opening a pathway and increasing the flow of fluid out of the eye
- In either case, the entire procedure takes approximately five minutes per eye
What You Can Expect After Surgery
Recovery time is typically one or two days, but every person is unique and your healing experience will depend on the underlying health of your eye and the ease of your surgery. That’s why it is imperative to plan regularly scheduled visits for your surgeon and technician to monitor your progress.
Blurry or foggy vision is typical immediately after surgery. Your eyes may feel somewhat sore and gritty, which is also normal. These symptoms will improve and redness and irritation will subside within a few days. Your eyes may also be slightly swollen and you may see red spots (superficial blood), but these symptoms will also disappear within weeks after surgery. You may also notice the formation of a blister-like bump, called a bleb, created by the fluid draining from the eye. Blebs are hidden by the eyelid, but they can alter how contact lenses fit on the eye and affect comfort.
- See your eye doctor within two days of surgery to check your eye pressure and look for signs of infection or inflammation
- Keep water out of the eye for two weeks
- Avoid driving, reading, bending and heavy lifting
- Do not rub your eyes or squeeze your eyelids immediately following surgery
- Expect drowsiness for several hours after surgery due to the Valium
- As soon as possible after surgery, get some sleep – and be sure to wear your protective eye shield
- When you awake, take the prescribed medication and eye drops; note, these may sting
- Wash your hands prior to using drops and do not touch the dropper to your eye
- If you have severe pain, severe loss of vision or a discharge other than tearing, please call our office anytime, 24/7
Ongoing Care Following Surgery
Filtering microsurgery is a high-reward procedure with exceptional statistics of success. Still, complications can arise and patients are encouraged to follow the strictest protocol to help ensure they maximize the results of their surgery. Vision can be blurred for up to six weeks after the surgery, but typically returns to pre-surgical levels. If you wear contact lenses, you may experience discomfort after surgery.
- Drive only once you feel your vision is clear
- Wait to wear contacts until getting the all-clear from your surgeon
- Wear the protective eye shields at bedtime or while napping for one week after surgery
- When showering and bathing, avoid getting water in your eyes for two weeks after surgery
- Do not swim or use a hot tub, sauna or any place with treated water for two weeks after surgery
- Resume normal exercise, but for contact sports wear eye protection for three months after surgery
- Purchase new makeup and brushes to avoid spreading bacteria from used products
- Avoid smokey and dusty rooms, and areas with chemical vapors, for two weeks after surgery
- Continue taking fish oil supplements
- Continue taking eye drops per your surgeon’s instructions
Laser Glaucoma Surgery
Proven methods in the hands of the eye experts.
Edina Eye leads the region in all forms of laser surgery, including specialized approaches to glaucoma. Advances in cool laser technology now make this type of surgery one of the ideal initial treatments for patients recently diagnosed with glaucoma, sometimes replacing eye drops.
Patients with open-angle glaucoma, the most common form of glaucoma, may choose laser surgery if they have difficulty administering eye drops or require an alleviation of eye pressure that the medication cannot achieve.
For patients with angle-closure glaucoma, laser surgery is often a first choice. In both instances, a cool laser is used to open a pathway for intraocular fluid to drain from the eye, reducing eye pressure and alleviating potential damage to the optic nerve.
What You Can Expect Prior to Surgery
If your doctor determines you require filtering microsurgery, you’ll set an appointment to meet your surgeon for a comprehensive eye exam and evaluation of your specific situation. At this consultation your surgeon will advise you when to begin each of the following steps:
- Take fish oil supplements to decrease dry eye symptoms
- Insert artificial tears (liquid drops) four times per day
- Stop wearing contact lenses
What You Can Expect During Surgery
You’ll be asked to arrive 45 minutes prior to surgery to sign various forms and receive post-operative instructions. At this time you will also meet again with your surgeon to answer any questions. Please note you can’t drive after surgery, so please make arrangements to have someone take care of your transportation.
- You will take a Valium to relax and settle back into a near-horizontal position in your surgical chair
- A special pillow keeps your head comfortable and still
- Anesthetic drops are applied to numb your eyes; additional drops are used throughout the procedure
- Your surgeon will place a special ring that gently applies pressure to flatten your cornea and hold the eye still
- This pressure, or suction, may be uncomfortable and darken your vision; this is normal, but is only temporary
- A lid speculum is placed into the eye to prevent blinking
- Cool laser light is focused on the eye’s trabecular meshwork, opening a pathway and increasing the flow of fluid out of the eye
- The entire procedure takes approximately five minutes per eye
What You Can Expect After Surgery
In general, patients can resume normal daily activities the next day after laser surgery. The procedure is usually performed in an eye doctor’s office or at an eye clinic. Before the surgery, your eye will be numbed with medicine. Your eye may be a bit irritated and your vision slightly blurry after the surgery. You should arrange a ride home after your surgery.
As with any type of surgery, laser surgery can carry some risks. Some people experience a short-term increase in their intraocular pressure (IOP) soon after surgery. With some surgeries there is a risk of the IOP dropping too low to maintain the eye’s normal metabolism and shape. The use of anti-glaucoma medication before and after surgery can help to reduce this risk. It’s also imperative you meet routinely with your eye doctor to monitor your post-surgery progress.
Recovery time is typically one or two days, but every person is unique and your healing experience will depend on the underlying health of your eye and the ease of your surgery. That’s why it is imperative to plan regularly scheduled visits for your surgeon and technician to monitor your progress. Blurry or foggy vision is typical immediately after surgery. Your eyes may feel somewhat sore and gritty, which is also normal. These symptoms will improve and redness and irritation will subside within a few days. Your eyes may also be slightly swollen and you may see red spots (superficial blood), but these symptoms will also disappear within weeks after surgery.
- Do not rub your eyes or squeeze your eyelids immediately following surgery
- Expect drowsiness for several hours after surgery due to the Valium
- As soon as possible after surgery, get some sleep – and be sure to wear your protective eye shield
- When you awake, take the prescribed medication and eye drops; note, these may sting
- Wash your hands prior to using drops and do not touch the dropper to your eye
- Meet your surgeon for your first post-op visit the day after surgery
- When you awake, take the prescribed medication and eye drops; note, these may sting
- Wash your hands prior to using drops and do not touch the dropper to your eye
- If you have severe pain, severe loss of vision or a discharge other than tearing — call our office anytime, 24/7
Ongoing Care Following Surgery
In most cases, medications are still necessary to control and maintain eye pressure. However, surgery may lessen the amount of medication needed.
- Drive only once you feel your vision is clear
- Wait to wear contacts until getting the all-clear from your surgeon
- Wear the protective eye shields at bedtime or while napping for one week after surgery
- When showering and bathing, avoid getting water in your eyes for two weeks after surgery
- Do not swim or use a hot tub, sauna or any place with treated water for two weeks after surgery
- Resume normal exercise, but for contact sports wear eye protection for three months after surgery
- Do not wear makeup or apply lotion for two weeks after surgery
- Purchase new makeup and brushes to avoid spreading bacteria from used products
- Avoid smokey and dusty rooms, and areas with chemical vapors, for two weeks after surgery
- Continue taking fish oil supplements
- Continue taking eye drops per your surgeon’s instructions
