What is Glaucoma?
Glaucoma describes a group of eye diseases in which the optic nerve is damaged. Most people with Glaucoma have high pressure within one or both eyes which can cause irreversible sight loss. Although there is no cure for Glaucoma, treatments can lower the intraocular pressure to slow down or prevent vision loss. For most patients, eye drops can reduce the eye pressure. However some patients need surgery if the Glaucoma is not being controlled by other methods.
The Decision to Operate
The most commonly performed ‘gold standard’ Glaucoma surgery is called a Trabeculectomy (a form of Glaucoma filtration surgery). All operations for Glaucoma are aimed at relieving the eye pressure by creating a new channel for the fluid to drain through. Unfortunately, the operation cannot restore vision that has already been lost from Glaucoma. New
developments in glaucoma surgery have led
to improvements in the safety profile and
surgical success. Glaucoma surgery can be
considered in patients with: advanced
disease on presentation, rapidly
progressively disease, intolerance and
noncompliance with medical treatment (eye
drops and tablets), or in cases in which
lower eye pressures are targeted which,
otherwise, would not be achieved with
medical or laser therapy. Other forms of
Glaucoma surgery include: insertion of drainage devices, laser techniques
(trabeculoplasty and cycloablation) and
nonpenetrating techniques of improving
aqueous drainage
What Happens During Surgery?
During a Trabeculectomy, a small hole is
created in the wall of the eye (the sclera)
and covered with a ‘trap door’. Fluid inside
the eye (aqueous) is then able to drain
through the trap door and out under the
clear outer coat of the eye (conjunctiva).
The fluid produces a ‘bleb’ and is usually
hidden under the upper eyelid. The fluid
which exits the eye becomes absorbed by
other eye tissues. Depending
on how well controlled the eye pressure is
following the surgery will determine
whether there is a need to continue the
Glaucoma drops.
How Successful is Glaucoma Filtration
Surgery?
The success rate of this form of glaucoma
surgery is variable worldwide and from
population to population but has generally
improved over the years as the surgical
technique improved. Local success rates are
unavailable at this time. In the United
Kingdom, the success rate ranges from 85
to 90 per cent. The risks associated with
trabeculectomy are small: too high or too
low eye pressure, infection and serious eye
bleeding (about 1 in 500), and cataract
formation (12 per cent). For patients not
wishing to have surgery for glaucoma control, it is advised to discuss alternative
options with the Ophthalmologist.
Uncontrolled, untreated Glaucoma carries a
greater risk of gradual, irreversible loss of
vision. The success of Glaucoma surgery is
very dependent on patient motivation and
coorperation However, it is essential that
the Surgeon and patient have common
goals and realistic expectations which can
be achieved.
AUTHOR: | Dr. Celeste Chambers |
DATE: | October 7, 2015 |
RESIDENCE: | Mandeville Regional Hospital (Consultant Ophthalmologist / Ophthalmic Surgeon) |
GENRE: | Ophthalmology, Biology, Medical Sciences |
WEBSITE: | www.ophthalsj.com |