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Dothan, AL 36305
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Glaucoma Surgery

 

The Leading Provider of Glaucoma Service and Treatment

Glaucoma is a common disease that causes irreversible blindness, if not detected and treated early. It is one of the leading causes of vision loss in the United States. It is often called the ‘silent thief of sight’ as it often does not present with any discernible change in vision until the disease is far advanced.

Glaucoma is usually associated with elevated intraocular pressure, which causes optic nerve damage and constriction of the field of vision, which eventually leads to blindness. There are two basic types of glaucoma; they can be classified as Open-angle glaucoma and Closed-angle glaucoma.

Symptoms of Glaucoma include:

  • Severe eye pain
  • Nausea and vomiting accompanying eye pain
  • Sudden onset of visual disturbance, often in low light
  • Loss of peripheral vision
  • Blurred vision
  • Rainbow-colored halos around lights
  • Eye redness
  • Headaches

There is no cure for the disease, but fortunately it is highly treatable. It can be controlled with medication, laser therapy or surgery. Glaucoma needs close follow up care, preferably by a Glaucoma Specialist, to prevent progression of the disease.

Surgical treatment options for Glaucoma include:

Laser Surgery

This is typically thought of as an intermediate step between drugs and traditional surgery, though long term success rates are variable. The most common procedure, trabeculoplasty, is performed for open angle glaucoma. It typically takes 10-15 minutes, and uses a laser beam to subtly modify the eye’s drainage system, thus reducing IOP. Complications from this procedure are minimal, and some patients are able to avoid or delay surgery, or eventually discontinue use of drops after this procedure.

  • Selective Laser Trabeculoplasty (SLT) – This procedure treats open angle glaucoma by using a laser to modify the trabecular meshwork of the eye, thereby increasing the drainage outflow and lowering IOP.
  • Laser Peripheral Iridotomy (LPI) – This is a treatment for angle closure glaucoma, which uses a laser to make an opening through the iris, allowing fluid to drain into the anterior chamber of the eye. This is used to prevent angle closure glaucoma attacks and to treat anatomically narrow angles.
  • Endoscopic Cyclophotocoagulation (ECP) – This procedure treats open angle glaucoma by destroying part of the ciliary body (cycloablation), which produces fluid in the eye. This is usually used in eyes with elevated IOP after having failed other more traditional treatments, or who are not good candidates for filtering surgery. It is usually performed simultaneously with Cataract surgery.
  • Cyclo G6 Micropulse Cyclophotocoagulation – This is a laser procedure that reduces IOP through cycloablation (destruction) of part of the ciliary body which produces fluid in the eye. It differs from ECP in that it is done without cataract surgery and involves no incision.

Conventional glaucoma surgery

  • Trabeculectomy – This is the most commonly used procedure to treat both open angle and closed angle glaucoma. The surgeon creates a passage in the sclera for draining excess eye fluid. Anti-fibrotic agents such as Mitomycin-C may also be used to prevent scarring and closure of the new opening. Approximately 50% of patients will no longer require drops for a significant period of time, and those who do require continued use of drops will generally have better control over their IOP.
  • Drainage Implant Surgery – This procedure involves use of one of several available drainage devices, which consist of a silicone tube that extends into the anterior chamber of the eye, allowing fluids to drain and reduce IOP. This procedure is preferred in patients whose IOP cannot be controlled with traditional surgery or who have previous scarring. These devices include Ahmed Glaucoma Valves, Baerveldt Glaucoma Implants and Molteno drainage tubes.

Minimally invasive glaucoma surgery

  • Trabectome – This is a probe-like device that is inserted into the anterior chamber through the cornea. The probe opens the eye’s drainage system through a small incision, delivers thermal energy to the trabecular meshwork, and reduces resistance to outflow of aqueous humor resulting in lowered IOP.
  • Canaloplasty – In this procedure, the surgeon uses an extremely fine catheter to clear the drainage canal, improving the aqueous circulation and reducing IOP.
  • Goniotomy with Kahook Dual Blade – used to treat open angle glaucoma by opening the eye’s natural drainage system and therefore reducing IOP.
  • Micro-invasive Glaucoma Surgery (MIGS) with Cataract surgery – This involves adding another step to cataract surgery that allows for treatment of Glaucoma also. This procedure implants a small drainage device into the eye such as iStent inject or Hydrus microstent, which is designed to reduce your eye pressure. This can be done at the same time as cataract surgery.
    • iStent – This procedure involves the implantation of two tiny drainage devices into the eye. It creates a permanent opening through the blockage in your eye’s drainage system to improve the outflow of fluid and lower IOP.
    • Hydrus microstent – allows for fluid outflow from the eye, as well as expands the eye’s natural drainage system to improve drainage of fluid and lower IOP.