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Pennsylvania Eye & Ear Surgery Center

Glaucoma Procedure

What Is Glaucoma?

Glaucoma is a disease that damages your eye’s optic nerve. The disease occurs when fluid builds up in the front part of your eye, increasing the pressure and damaging the optic nerve. When damage to these fibers occurs, blind spots develop. These blind spots, however, usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results. Vision loss from glaucoma is permanent but the disease can be slowed down or stopped. This is why early detection is essential.

The most common early treatment for glaucoma includes eye drops or medications and laser procedures to relieve eye pressure and prevent future vision loss. In severe cases, glaucoma surgery like those performed at Pennsylvania Eye & Ear Surgery Center may be necessary.

What Are Glaucoma Surgery Options?

Your ophthalmologist will probably recommend a treatment course that helps eye fluid drain from the eye to reduce intraocular pressure, and thus, lower the chances of causing stress and damage to the optic nerve. Our glaucoma specialists offer some of the latest and most innovative techniques to deliver quality results and years of sustained vision for those afflicted with this disease.

Minimally Invasive Glaucoma Procedures

Clinical research and trials have created new and exciting surgical methods for treating glaucoma patients. These include:

  • iStent

Implanted during cataract surgery, iStent includes two two tiny stents that are designed to restore your eye’s natural ability to drain fluid and reduce intraocular pressure. They are the smallest medical implants to be placed in the human body.

  • Xen

The XEN Gel Stent allows us to treat patients with moderate to severe glaucoma, with less risk and much faster recovery time than the traditional trabeculectomy or tube shunt. The implant creates a small channel to drain eye fluid and lower pressure.

  • Omni
the OMNI 360 is the only device that combines two well-established minimally invasive glaucoma surgery (MIGS procedures) into one using a single device and a single clear corneal incision. The procedure consists of expanding the eye’s natural drain as well as removing the drain’s point of resistance.
  • Hydrus
This procedure features a minimally invasive FDA-approved implantable device for the treatment of open angle glaucoma. Since it is performed at the same time as cataract surgery, no additional incisions are necessary. The Hydrus is a microstent that is inserted into the eye’s natural drain and is about the size of an eyelash

Laser Surgery

  • Laser Peripheral Iridotomy

This is for people who have angle-closure glaucoma or “narrow angles”. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle.

  • Selective Laser Trabeculoplasty
This surgery is for people who have open-angle glaucoma and can be used instead of or in addition to medications. The eye surgeon uses a laser to make the drainage angle work better. That way fluid flows out properly and eye pressure is reduced.

Traditional Glaucoma Surgeries

  • Trabeculectomy
This is where your eye surgeon creates a tiny flap in the sclera. They will also create a bubble (like a pocket) in the conjunctiva called a filtration bleb. It is usually hidden under the upper eyelid and cannot be seen. Aqueous humor will be able to drain out of the eye through the flap and into the bleb. In the bleb, the fluid is absorbed by tissue around your eye, lowering eye pressure.
  • Glaucoma Drainage Devices or Tube Shunt

Your ophthalmologist may implant a tiny drainage tube in your eye. The glaucoma drainage implant sends the fluid to a collection area (called a reservoir). Your eye surgeon creates this reservoir beneath the conjunctiva. The fluid is then absorbed into nearby blood vessels. Different types of tube shunts exist and your surgeon will recommend the tube shunt best for your glaucoma.

Who Will Perform My Procedure?

Each of our glaucoma specialists is board-certified and fellowship trained. That’s quality and experience you can trust. We utilize the latest technology and enjoy an excellent reputation and high patient satisfaction. From the first moment a friendly staff member greets you, throughout your treatment, you’ll receive compassionate care and personal attention. Here are just a few of our practitioners who perform this procedure:

Christina M. Lippe, MD

Christina M. Lippe, MD

Cataract, Oculoplastics
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Michael A. Malstrom, MD

Michael A. Malstrom, MD

Cataract
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Mehul H. Nagarsheth, MD

Mehul H. Nagarsheth, MD

Cataract, Glaucoma
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Abhishek K. Nemani, MD

Abhishek K. Nemani, MD

Cataract, Glaucoma
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Michael Smith, MD

Michael Smith, MD

Cataract, Glaucoma
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What Happens After The Procedure?

After the surgery is complete, your doctor may place a shield over your eye. After a short stay in the outpatient recovery area, you’ll be ready to go home. If you undergo minimally invasive glaucoma surgery, your recovery will be similar to cataract surgery alone. Typical follow-up visits are a day after your surgery, the following week, and a month later to monitor your progress.

What Are The Risks Of Surgery for Glaucoma?

The following are (rare) glaucoma surgery risks or side effects to discuss with your doctor:

  • Vision loss and blindness
  • Bleeding in the eye
  • Infection
  • Low eye pressure (or hypotony)
  • Scarring and surgical failure
  • Cataract formation
  • Need for additional surgery

Your ophthalmologist will talk with you about the risks and side effects of your particular glaucoma surgery. When it comes to surgical intervention for advanced glaucoma cases, the benefits typically outweigh the risks. Your surgeon will review your unique clinical situation and recommend the best surgical treatment to preserve your vision.

Some material adapted from the American Academy of Ophthalmology.