Glaucoma, What Does The Operation Involve?

Glaucoma is a chronic eye disease that progressively affects the optic nerve and affects the field of vision (bilateral then frontal).

Linked to the increase in eye pressure, glaucoma is a pathology to be taken seriously in order to maintain good visual comfort for as long as possible.

Thus, it is sometimes necessary to have glaucoma surgery.  In this article, experts from JLR eye hospital will give you a little comparison of types of glaucoma treatment to decide which is the ideal for your vision.

The operation for glaucoma, in which case?

Although there is not yet a cure for glaucoma, several types of glaucoma treatment (eye drops, laser, surgery) may be offered to slow its progression, depending on the stage of the disease.

If treatment with eye drops (1 st phase drops installation) and treatment with laser (2 nd phase) to facilitate the evacuation or decrease the production of aqueous humor is no longer sufficient to control intraocular pressure effectively, your ophthalmologist specialist in glaucoma can direct you to the treatment of glaucoma by operation.

Indeed, it is possible that your disease is detected too late or that its state is relatively advanced then risking permanent loss of vision.

Glaucoma operation is then necessary. Each case being specific, for which the treatment will be personalized, do not hesitate to ask all your questions to our glaucoma specialists. Monitoring for glaucoma should be done throughout your life.

Risks and results

All treatments for glaucoma increase the risk of getting cataracts. However, the risks are greater without treatment for glaucoma, as this eye disorder can greatly impair vision and lead to blindness if left untreated.

The glaucoma operation doesn’t permit visual recovery of the sores that have shown up, they are irreversible.

Glaucoma and cataract combined surgery

It is possible and recommended to perform a so-called combined surgery when you want to treat glaucoma and cataracts (clouding of the lens). These two pathologies are linked to aging, it is not uncommon to contract them at the same time.

The operation is then a little longer but the operating mode remains the same. The intervention allows for better results on vision recovery (related to cataracts) and lighter treatment (one anesthesia, fewer potential complications).

However, this intervention remains a surgical act in which there are risks, which is why the advice of your ophthalmologist is essential.

The course of a glaucoma operation

After carrying out a preoperative assessment (anesthetic consultation, surgeon’s check on contraindications, etc.), glaucoma surgery is performed under local anesthesia (injection or instillation of drops) in the sterile operating room by a specialized ophthalmologist.

Using a microscope, the operation consists in making an incision on the eye to evacuate the aqueous humor out of the eye under the conjunctiva by creating a valve (trabeculectomy or deep non-perforating sclerectomy, the choice of the type of intervention depends on criteria related to your glaucoma that only your ophthalmologist is able to assess) and lower eye pressure.

The strategy for the most part keeps going under 60 minutes. A temporary dressing (eliminated at the first post-operative consultation) is at long last positioned on the operated eye.

The healing will be checked consistently, it is subsequently important to plan a few meetings with your ophthalmologist.

How do you feel after the operation?

Once the effect of the anesthesia has worn off, it is common to feel discomfort, especially with a grain of sand. This discomfort can last for several days. In general, burning pain or grains of sand are not worrying. On the other hand, the appearance of pain felt internal, must warn the surgeon of urgency. It may indeed be an infection that needs to be treated urgently.

A temporary decrease in visual acuity is not uncommon. It can be linked in particular to the dilation of the pupil, to a very low intraocular pressure, or even to the presence of blood in the eye.

What precautions should be taken after the operation?

It is absolutely necessary to refrain from touching the operated eye. The drops that were put on before the operation must be stopped.

The day after the operation, the surgeon will prescribe new drops which are intended to prevent infection and limit scarring of the conjunctiva.

Professional activity, the use of dangerous machines or instruments, driving a car, and sporting activities are not recommended for a limited period which will be defined on a case-by-case basis by your surgeon.

How should the post-operative consultations go?

This depends on the surgeon and the type of surgery performed. A check the day after the operation allows to check the intraocular pressure and especially the tightness of the conjunctival bubble. If a large or prolonged leak exists, additional sutures may be required.

A check around the fourth and then the eighth day checks the intraocular pressure. In the event of trabeculectomy, if the pressure remains too high, part of the sutures placed on the scleral flap is laser cut or else removed.

Additional checks are often necessary. Unlike cataracts, which require little participation from the patient once the operation is performed, these operations require frequent checks and possible adjustments unless the long-term result is compromised.