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Glaucoma is a condition in which the intra-ocular pressure (IOP), the pressure within the eye, increases. If it reaches a certain level the pressure can damage the nerves within the retina and the optic nerve itself. Modern diagnostic equipment can detect glaucoma at a very early stage, increasing the likelihood of successful treatment and preventing loss of vision.

Glaucoma surgery uses a range of methods to reduce the intra-ocular pressure, either by increasing the out flow of fluid from the eye, or reducing the number of cells available to produce the fluid.

When is glaucoma surgery used?

Glaucoma surgery is generally only used when other treatments, such as medication given in eye drops, have failed to reduce IOP sufficiently. It can also be used if you are unable to tolerate the drugs used in the eye drops, or where there they cause significant side effects.

Glaucoma surgery may also be required in cases of neovascular glaucoma, often caused by diabetes, where blood vessels have grown in the drainage area of the eye blocking the exit of fluid.

Laser surgery for glaucoma

In most cases, laser surgery will be the first surgical treatment option for glaucoma. Laser surgery represents a bridge between drug treatments and full surgery. 

Laser glaucoma surgery procedures include:

• Laser trabeculoplasty. Lasers are used to subtly alter the structure of the trabecular meshwork and improve drainage from the eye. This is primarily performed in cases of open-angle glaucoma.
• Laser peripheral iridotomy. A laser is used to make a small hole in the iris through which fluid can drain, bypassing the blocked meshwork. This is primarily used in angle-closure glaucoma.
• Cycloablation . A laser destroys a small section of the ciliary body that produces the fluid. This can be done from outside the eye (trans-scleral cycloablation) or using a small probe inserted into the eye (endoscopic cycloablation).

Traditional surgery for glaucoma

If drug therapy and laser treatment fail to reduce IOP sufficiently, you will need traditional surgery to treat your glaucoma. Several surgical techniques are used, including:

• Trabeculectomy, which creates a small hole through the white of the eye through which fluid can drain.
• Deep sclerectomy. The surgeon does not penetrate the white of the eye, but skims the surface sufficiently to allow fluid to seep through.
• Aqueous shunt implant. A fine tube or filament in implanted that drains fluid to the back of the eye where it is reabsorbed.

What to expect after glaucoma surgery

Glaucoma surgery is successful in around three quarters of cases, although it may take some time for the pressure within your eye to fully adjust. During this period you will need to continue using other medication such as eye drops until your ophthalmologist either changes or stops your prescription.

Risks and complications of glaucoma surgery

Different complications can arise with the different types of surgery.

If you have trabeculectomy and deep sclerectomy, there is a risk that the surgically created drain site will start to heal and further surgery may be required to re-establish the drain.

Implant surgery always carries the risk of rejection and inflammation of the eye tissues. Implant tubes may become blocked and cease to function. On rare occasions, the implant can be too effective, causing a drop in intraocular pressure, which creates a condition called hypotony.

Submit a request for further information, a quotation or indicative cost. Your enquiry will be forwarded to up to 3 private healthcare providers. They will respond directly with further information.

Get a quote for a private glaucoma surgery >