What is glaucoma surgery?

Surgery for glaucoma reduces the pressure in the eyes by allowing fluid to drain. It opens blocked drainage angles or creates a new opening so fluid can drain.

Doctors can use either a surgical cutting tool or a laser to do surgery. Laser surgery is usually tried first. If it doesn't help, your doctor may try conventional surgery.

There are three basic types of surgery:

• Surgery to increase drainage of fluid from the eye. The surgeon may remove a piece of tissue to allow fluid to drain from the eye. Or a stent or tube may be placed in the eye to allow fluid to drain.
• Surgery to prevent the drainage angle from closing. The surgeon makes a new opening in the colored part of the eye (iris). It allows fluid to flow through the eye.
• Surgery to decrease the amount of fluid produced in the eye.

Cataracts may occur in people who also have glaucoma. This commonly occurs in older adults.

If you have glaucoma and cataracts, you may consider having surgery for both conditions at the same time. Depending on which condition caused the vision loss, you may have improved vision after surgery.

• If the vision loss before surgery was mostly caused by the cataract, you may have noticeable improvement in your vision. Also, surgery may delay the progression of vision loss caused by glaucoma.
• If the vision loss before surgery was mostly caused by glaucoma, rather than the cataract, you may not have much improvement in vision after surgery. But surgery may slow the loss of vision caused by glaucoma.

Cataract surgery alone is quicker and less complicated than having both surgeries at the same time.

In many cases where glaucoma and cataracts occur together, surgery to treat both conditions may be done at the same time.

If you have both glaucoma and cataracts, talk with your doctor about the benefits and risks of combined surgery to treat both conditions.

Deciding whether to have surgery for glaucoma can be hard. Here are some reasons.

• You may not be in pain or notice any vision loss.
• Your vision may get worse right after surgery and may be affected for weeks or months. Your eyesight may not be as good as it was before surgery.
• Surgery isn't a complete cure for glaucoma. But surgery can decrease the chance of losing even more eyesight later. And for some people, it can reduce or get rid of the need for eyedrops.
• Not everyone who has laser surgery will have lower pressure in the eye after surgery. The lower pressure may last only a few years.
• The effects of some laser treatments aren't long-lasting. Other treatments may be needed later.