Treatment of Glaucoma

How is glaucoma treated?

There are three main ways to treat glaucoma.

Medications

First, the patient's eye pressure is lowered either by reducing the production of fluid in the eye or by increasing its output. There are medications used for these two methods. These medications are drops that are taken at regular intervals every day and used lifelong. Since each patient responds differently to these drops and there may be side effects, your doctor chooses the medication that will be suitable for you and observes the result. It is very important for patients using medications to be followed up at intervals that their doctor deems appropriate, because, over time, a decrease in medication response may develop. In this case, it may be necessary to change the medication, add another medication or resort to additional methods such as laser treatment and surgical treatment.

Laser treatment

In the treatment of glaucoma, a laser beam is first used in the treatment of acute glaucoma to prevent the other eye from entering glaucoma. Secondly, in cases of chronic glaucoma, the laser is applied to the filter-like outflow channels to facilitate the outflow of the fluid of the eye. These two laser treatment methods are outpatient treatments without the need for an operating room. Another usage area of ​​laser in the treatment of eye pressure is the application of laser to the white area around the colored part of the outer part of the eye. The aim is to reduce the production of eye flıid by destroying the region inside this part that secretes eye fluid. This treatment method is performed in the operating room environment, usually with local anesthesia, and the patient can go home the same day.

Surgical treatment

If the patient's eye pressure does not decrease and the disease continues to progress despite medications or laser treatment, the treatment method to be applied is mostly surgery. Depending on the stage of glaucoma and the condition of the eye, the doctor applies one of the various surgical techniques to the patient.

What is a trabeculectomy?

Surgeries that aim to drain the eye fluid into the vessels outside the eye are the most frequently performed surgeries. The first of these, also called trabeculectomy surgery, is the operation in which new thin channels are created in the eyewall so the fluid that cannot be adequately discharged from the eye can be filtered to the vessels outside the eyeball. This surgical method, which is mostly applied under local anesthesia and sometimes under general anesthesia, is the most frequently applied method for years and its results and complications are well known. Its effectiveness is also quite high. Although it is perceived as a single type of surgery, the surgeon can make modifications to this surgical method depending on the condition of the eye. It is also possible to perform this surgery together with cataract surgery. Some current implants aim to drain eye fluid in this way. The function of the above-mentioned canaliculi is here made of very thin tubes made of different materials, the ends of which are placed inside the eye.

What are minimally invasive glaucoma surgeries?

In some new methods, also called minimally invasive surgical methods, there are various methods with or without implants in which the fluid of the eye is directed to the eye's excretory duct system. In these methods, the healing of the eye may be shorter, but their effectiveness may not always be as much as in trabeculectomy surgery. In appropriate cases, very satisfactory results are obtained. Your doctor will inform you about the advantages and disadvantages of the method he will apply during the pre-operative decision stage. Another common application of these methods is the application of them together with cataract surgery.

What is tube implantation?

In the method called seton or tube surgery, eye pressure is controlled with implants, which are the thin tube part in the silicone structure placed inside the eye and the reservoir part placed between the layers outside the eyeball, which allow the eye fluid to discharge to the capillaries outside the eye. These implants are made of a material compatible with the eye and have a compatible design, so they are permanent in the eye.

What are cyclodestructive operations?

Another way of glaucoma surgery is to reduce the production of eye fluid. This was formerly accomplished by the cryodestruction method, also known as the freezing method. It has recently been done using a diode laser. In this method, the laser is applied to the white area around the colored part of the outer part of the eye. The aim is to reduce the production of eye fluid by destroying the region inside this part that secretes eye fluid. This treatment method is performed in the operating room environment, usually with local anesthesia, and the patient can go home the same day.

Do infants get glaucoma?

Although rare, glaucoma can also be seen in infants and its treatment is surgery without delay. Some different surgeries are performed in infants than in adult glaucoma. In cases with no response, one or more of the above-mentioned methods can be applied.

What are other methods?

In rare glaucoma types where the eye anatomy is different, the above-mentioned surgeries can be combined with additional interventions. Sometimes, surgeries such as vitrectomy and keratoplasty can be combined with glaucoma surgery.

The glaucoma laser treatments and surgeries performed at Dünyagöz Hospitals are listed below:

• Laser trabeculoplasty
• Laser iridotomy
• Laser iridoplasty
• Infant glaucoma examination/follow-up under general anesthesia
• Ab-interno surgeries for glaucoma in infants
• Ab-externo surgeries for glaucoma in infants
• Trabectome surgery
• Gonioscopy-assisted transluminal trabeculotomy
• Canaloplasty
• Xen implant surgery
• Deep sclerectomy
• Viscocanalostomy
• Trabeculectomy
• Kahook dual blade surgery
• Tube implantation (Ahmed Valve surgery)
• Cyclocryodestruction
• Diode laser cyclodestruction
• Bleb revision
• Combined surgeries for cataracts and glaucoma
• Various combined surgeries in complicated cases

People who have had glaucoma surgery should maintain regular glaucoma follow-ups.

Prepared by the Dünyagöz Hospital Editorial Board.

*Page content is for informational purposes only. Consult your doctor for diagnosis and treatment