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When deciding on a treatment option, your physician at the Kaufman Eye Institute will take into account the unique aspects of your individual case, including severity of the disease, response to medication and other health issues.
The most common treatment for glaucoma are eye drops. There are a number of different categories of eye drops, but all are used to either decrease the amount of fluid produced in the eye or improve its outward flow. Sometimes doctors will prescribe a combination of eye drops. People using these medications should be aware of their purpose and potential side effects. Our physicians will decide which medications are best suited for each patient based on the individual case of glaucoma, medical history and current medication regimen.
Trabeculoplasty is often used to treat open-angle glaucoma. In argon laser trabeculoplasty (ALT), a high-energy laser is aimed at the trabecular meshwork to open areas in these clogged canals. These openings allow fluid to bypass drainage canals and flow out of the eye easier. Argon laser trabeculoplasty has successfully lowered eye pressure in up to 75 percent of patients treated. This type of laser can be performed only two to three times in each eye over a lifetime. This is performed in all of our offices
Laser peripheral iridotomy (LPI) is frequently used to treat closed-angle glaucoma and narrow angles, in which the angle between the iris and the cornea is too small and blocks fluid out flow of the eye. In LPI, a laser creates a small hole in the iris to allow fluid drainage. LPI is the preferred method for managing a wide variety of angle-closure glaucomas that have some degree of pupillary blockage. This laser is most often used to treat an anatomically narrow angles and prevent angle-closure glaucoma attacks.
When is a trabeculectomy surgery indicated?
Trabeculectomy is generally recommended for patients with glaucoma that continues to progress despite use of medications and/or laser treatments. Sometimes this surgery can be combined with cataract surgery.
What is done during trabeculectomy surgery?
A new drainage site is created to facilitate drainage of fluid FROM the eye. Instead of draining INTO the normal drainage site of the eye (the trabecular meshwork), the fluid is drained INTO a new space (a "bleb") that is completely covered by the white outer covering (the conjuctiva) of the eye. This will lower the eye pressure. Since the surgery is usually performed near the top of the eye, the area of surgery can not be seen afterwards because it is behind the upper eyelid.
Will my glaucoma be cured with trabeculectomy surgery?
No. Any vision that is already lost prior to the surgery, in general, will not return. Trabeculectomy surgery only lowers your eye pressure. By lowering the eye pressure, the goal is to either stop or slow down you loss of vision. Sometimes this goal is not possible.
Currently, laser surgery is the most frequently used procedure to treat glaucoma. It normally lowers eye pressure, but the length of time that pressure remains low depends on many factors, including age of the patient, the type of glaucoma and other medical conditions that may be present. In many cases, continued medication is necessary, but potentially in lower amounts.