WHAT IS GLAUCOMA?
Glaucoma is an augment in pressure inside your eye. There is an inability to drain fluid in the natural way. This causes damage to the optic nerve of the eye(s) leading to vision impairment.
The type of glaucoma is decisive for treatment. Primary open-angle glaucoma, the commonest glaucoma type treated with topical eye drops. Laser therapy advised when the conservative mode is unable to show any positive response. The gone vision can never be brought back, but the intention of the medication is to diminish the pressure.
Primary angle closure
Initially with medication for pressure reduction and then use of laser therapy
According to the etiology, the treatment can range from eye drops to laser treatment to surgery
Surgery is the only option
The main objective of laser surgery is to reduce intraocular pressure by draining the fluid from the eyes. The types of OPD based laser procedures are:
- Trabeculoplasty: This surgery is for people with open-angle glaucoma. The eye surgeon employs a laser to boost the drainage angle. This allows the fluid to flow out, thereby reducing eye pressure.
- Cyclodiode laser treatment: This treatment helps in destroying the fluid-producing tissues present in the eye and this also helps in pressure reduction in the eye.
- Iridotomy: This is for the ones who have glaucoma from the angle closure. The ophthalmologist produces a tiny hole in the iris using a laser. This hole supports air motion to the point of drainage.
Operating room surgery:
The following surgeries are performed in an operating room setup.
- It provides a new gutter for drain to move from the eye for the aqueous humor.
- Trabeculectomy: A flap made in the sclera by the surgeon drains the fluid into the bleb (made in the conjunctiva). And the surrounding tissue of the eye absorbs this fluid, thereby reducing the pressure.
- Glaucoma drainage devices: After creating a reservoir under the conjunctiva, a tiny drainage tube implantation is done, which drains the fluid into this reservoir. The drained fluid is absorbed by the surrounding blood vessels.
Other types of glaucoma surgery:
- Trabeculotomy: Trabeculotomy, like trabeculectomy, is an operative procedure. A tissue slit in the drainage angle of the eye is excised. Fluid (aqueous humor) will now drain out of the eye from this new hole. The surgeon does trabeculotomy only in children.
- Viscocanalostomy: In this procedure, the sclera is removed enabling the drainage of fluid easily from the eyes. A viscoelastic material is inserted.
- Deep sclerectomy: Deep Sclerectomy is a non-penetrative surgical practice for treating open-angle glaucoma.
- Trabecular stent bypass: Effective drainage of fluid made by a tiny tube placed inside the eye.
Advanced technology is helping create a superficial incision without deeply penetrating the eye, with very few complications.
Deep sclerectomy is such a procedure. A superficial incision made in the sclera allows for fluid drainage, reducing the pressure.
RISKS INVOLVED WITH THE PROCEDURE
- Eye pain or redness
- Eye pressure that is still excessively high or even excessively low
- Loss of vision
- Bleeding in your eye
There can be a recurrence of pressure over time, for which medication needs to be taken as prescribed.
- Recovery is dependent on the individual patient, but generally it takes around 6 weeks for the healing process.
OUTCOME OF SURGERY
- The outcome of this surgery is very good.
- It is important to keep a communication with the surgeon and to visit the hospital / clinic for regular follow-ups as advised.
CARE AFTER SURGERY
- Avoid rubbing or scratching of eyes
- Take all medications properly as prescribed
- Avoid strenuous activities such as gym or lifting heavy objects
- Avoid taking a dip in swimming pools or tubs as infection can be caught from these places very easily