Surgical Treatment of Glaucoma

ID-10057746The aim of glaucoma management/treatment is to avoid damage to optic nerve and other complications due to glaucoma or raised intra ocular pressure and to preserve vision to maintain quality of life of the patient to close to normal as possible with minimal side effects. To achieve the aim of treatment of glaucoma, it is important to select an appropriate treatment option for individual patients and proper follow-up.

Surgical treatment of glaucoma is the primary treatment option (primary treatment option) for congenital glaucoma and also important for closed angle glaucoma. Surgery however may not (and usually do not cure) cure glaucoma and it is a temporary solution. Both laser surgery, as well as conventional surgeries are performed for treatment of glaucoma.

Some surgical procedures performed for treatment of glaucoma are canaloplasty, trabeculectomy, drainage implant, Laser-assisted non-penetrating deep sclerectomy, LASER surgery etc.

Canaloplasty:

It is a non-penetrating surgical procedure, where micro-catheter technology is used. This procedure is meant to improve drainage of aqueous humor through Canal of Schlemm by enlarging the canal using micro-catheter. By enlarging the Canal of Schlemm, it is possible to reduce intra ocular pressure in selected glaucoma patients (such as closed angle glaucoma).

Trabeculectomy:

This is a conventional surgery performed for treatment of glaucoma. Here, a portion of trabecular meshwork is removed to reduce intra ocular pressure. The surgery may lead to scarring and loss of effectiveness of the procedure.

Laser-assisted non-penetrating deep sclerectomy:

This procedure is a modified version of trabeculectomy. In this procedure de-roofing of Canal of Schlemm is done to facilitate drainage of aqueous humor.

Drainage implant:

In this procedure, a drainage tube is inserted into the anterior chamber for drainage of aqueous humor. This procedure is usually done in patients for whom previous surgery (e.g. trabeculectomy) has failed de to side effects or in patients who do not respond adequately despite maximal medical therapy.

Laser surgery:

Laser surgery (Argon laser trabeculoplasty or ALT) is used for treatment of open angle glaucoma. It is a temporary solution for open angle glaucoma and not cure for the disease.

Depending on the type of glaucoma and individual requirement of the patient, the treatment modality (such as medications, various surgical procedures etc.) for glaucoma should be individualized.

“Image courtesy of Apple’s Eyes Studio / FreeDigitalPhotos.net”.

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