Glaucoma is a progressive eye disease that affects the optic nerve. The optic nerve carries messages from the eye to the brain. At Cape Fear Eye Associates, PA, in Fayetteville, NC, your resource for ophthalmology services, we diagnose and treat glaucoma, including surgery. If you have glaucoma, it is critical to decrease and control your intraocular pressure (IOP) in order to preserve your eyesight. Depending on the type and severity of the condition, there are numerous treatments available to effectively treat glaucoma.
Medication (eye drops) are the most common form of treatment for glaucoma; however, there are side effects, and medications aren’t effective for all patients, and you must remember to take your medication every day. There are a number of different categories of eye drops, but all are used to either decrease the amount of fluid (aqueous humor) in the eye or to improve the outflow of this fluid in order to stabilize or reduce intraocular pressure. Your doctor will decide which medications are best suited to you based on a number of considerations, including your medical history and current medication regimen. Your doctor may also elect to prescribe a combination of eye drops.
Selective Laser Trabeculoplasty (SLT)
SLT or Selective Laser Trabeculoplasty, is a gentle, low-energy laser therapy, which triggers a natural healing response in the eye in order to reduce IOP. SLT effectively lowers IOP in the majority of patients, but the length of time that pressure remains low depends on many factors, including the age of the patient, the type of glaucoma, and other medical conditions that may be present. In some cases medication may still be necessary, but in reduced amounts. SLT is suitable for use across the entire glaucoma treatment spectrum, but it is most effective when used as a first-line therapy in newly diagnosed glaucoma patients.
The main benefit of glaucoma surgery is reducing the pressure in the eyes. Glaucoma that is spotted early can prevent irreversible damage to the optic nerve. The main goal of surgery is to slow the advancement of the disease since there is not a cure for the damage caused by it. Many patients report a positive result from glaucoma surgery.
Preparing for Glaucoma Surgery
We like to prepare our patients in advance for surgery. You will need to arrange transportation to and from surgery. It's also possible that you will need to have a physical exam to ensure you are healthy enough for the surgery. An eye doctor from our team will complete a pre-operative evaluation with you to explain all the expectations leading up to surgery.
During Glaucoma Surgery
Glaucoma surgery involves making a small incision to drain the fluid and release pressure on the eyes. The surgery will typically take about one hour to complete. After surgery, there is mild discomfort, but it is usually manageable without pain medication. An eye doctor on our team will explain what to expect during the surgery so you are prepared.
Trabeculectomy is a surgical procedure usually reserved for glaucoma patients for whom medication and laser therapy have not proved effective. During the procedure, the eye is numbed with a local anesthetic and a small incision is made in the white of the eye. A tiny portion of the spongy meshwork is removed to improve fluid drainage, resulting in reduced eye pressure. If this procedure does not reduce eye pressure to the optimal level, medication may be necessary.
Tube/shunt surgery involves placing a tube through which the aqueous will exit the eye and a valve placed on the eye’s surface to regulate the flow.
Drainage Implant Surgery
Drainage implants are small silicone tubes that are surgically placed into the eye behind the cornea. They make it easier for fluid to flow out of the eye and into adjacent capillaries and tissues, where it is reabsorbed by the body. While drainage implants do not improve vision, they can be highly effective at reducing pressure in the eye, which helps to prevent damage to the optic nerve. Drainage implant surgery is typically reserved for more complex glaucoma cases.
Minimally Invasive Glaucoma Surgeries (MIGS) refer to a number of devices/techniques that are used to address one or two of the areas of outflow resistance associated with IOP in glaucoma patients. Typically performed during cataract surgery, these procedures are said to be quicker and safer than traditional glaucoma surgery.
Indications for MIGS are different compared to invasive glaucoma surgeries and do not include patients with advanced disease or patients who require very low unmedicated postoperative IOP.
After Glaucoma Surgery
The recovery time varies for each patient, but most of our patients heal within six weeks after surgery. You should stay home and relax after the first couple of days. Also, you should refrain from heavy lifting, exercise, or other strenuous activities. You can resume driving and other everyday activities after a few days.
It's important not to scratch or rub your eyes after surgery. It's normal to have some blurry vision or itchy sensations. It's also essential to follow the prescribed eye drops to avoid infection. We will schedule follow-up visits to ensure that you are healing correctly.
At Cape Fear Eye Associates, PA, we are ophthalmology specialists that take pride in glaucoma surgery. We treat patients in the Fayetteville, NC, area with all stages of glaucoma. Contact our office to learn more about glaucoma surgery, diagnosis, and treatment. Call us at (910) 484-2284 to book an appointment today.