Filtering surgery is usually done in a hospital or outpatient surgery center, with local anesthesia, and sometimes, sedation. The surgeon uses very delicate instruments to remove a tiny piece of the wall of the eye (the sclera), leaving a tiny hole. The aqueous can then drain through the hole, reducing the intraocular pressure, and be reabsorbed into the bloodstream.
In some cases, the surgeon may place a small tube or valve in the eye through a tiny incision in the sclera. The valve acts a regulator for the buildup of aqueous within the eye. When the intraocular pressure reaches a certain level, the valve opens, allowing the fluid to flow out of the eye’s interior, where it can be reabsorbed by the body. The procedure may take place in the ophthalmologist’s office or outpatient surgical center, and can be done under local anesthesia.
The recuperative period following incisional glaucoma surgery is usually short. You may need to wear an eye patch for a few days after surgery, and to avoid activities which expose the eye to water, such as showering or swimming. The ophthalmologist may recommend that you refrain from heavy exercise, straining or driving for a short time after surgery, to avoid complications.
As with all surgery, there are risks associated with glaucoma surgery. Complications are unusual, but can include:
- undesirable changes in intraocular pressure
- loss of vision
Sometimes, a single surgical procedure is not effective in halting the progress of an person’s glaucoma. In these cases, repeat surgery, and/or continued treatment with topical or oral medications may be necessary.
Your age, eye structure, type of glaucoma, and other medical conditions are all considerations when deciding how to treat your glaucoma.
The ophthalmologist, in partnership with the patient, is best able to make the appropriate treatment decisions.
Before your surgery: (TIPS)
1. Make sure you understand the risks and benefits of the surgery. Here are some questions you may want to ask your ophthalmologist:
- Why do you think surgery is the best treatment for my condition?
- What kind of surgery do you recommend for my condition, and why?
- Are there other treatment options I should consider?
- What do you think might happen if I don’t have the surgery?
- Do you think I am likely to need further treatment after the surgery (i.e. medication or further surgery)?
- What change should I expect in my condition after surgery?
- What kind of anesthesia will you use for my surgery?
- Where will my surgery take place?
- Approximately how long will my surgery take?
- Should I discontinue any of my medications prior to surgery? If so, how long before my surgery should I stop taking them?
- Can I eat prior to my surgery?
You might find it helpful to write your questions down prior to your office visit, or to take notes during your appointment. This can help ensure you understand everything your ophthalmologist discusses with you.
2. If you have medical insurance, you should find out if your policy will cover your surgery, and how much – if anything – you should expect to pay out of pocket.
3. Most importantly, don’t be afraid to ask your ophthalmologist questions. If you have any concerns, now is the time to discuss them with your doctor.
The day of your surgery:
- If you’ve been told not to eat before surgery, it is very important that you follow that instruction. It can be dangerous to eat prior to undergoing some kinds of anesthesia.
- Most hospitals and outpatient facilities recommend you leave valuables, such as money or jewelry at home. You may not be allowed to take those items into the procedure room.
- If you are having your procedure in a hospital or outpatient surgery facility, make sure you get there in time to fill out any registration forms that may be required.