Glaucoma Treatment- Minimally Invasive Surgery

Pristyn Care is associated with some of the best eye hospitals for glaucoma surgery in India. All our associated clinics and eye hospitals are equipped with modern amenities and advanced medical infrastructure to ensure a smooth surgery experience.

Additionally, the following factors make Pristyn Care a coveted and trusted healthcare name for glaucoma treatment:

• Treatment in an affordable price
• Availability of experienced and skilled eye surgeons
• All medical facilities under one roof
• Experienced and empathetic paramedical staff
• Highly positive success record

Typically, a regular eye examination is enough to diagnose and confirm the condition of glaucoma. However, for an accurate diagnosis, the eye specialist may recommend the following tests-

• Eye Pressure Test (Tonometry)- A special device (tonometer) is used to measure eye pressure that gives an insight into whether the intraocular pressure is above the normal range.
• Gonioscopy- It examines the iris and the cornea. It determines whether the angle or area from where the fluids drain out is open or closed. It helps to identify which type of glaucoma the patient has.
• Visual Field Test (Perimetry)- This test involves checking the patient’s complete field of vision, especially peripheral vision. A sequence of light spots is shown to the patients to identify which ones the patient can see.
• Optic Nerve Assessment- The optic nerve is examined with the help of a slit lamp or optical coherence tomography (OCT).

Depending on the results of these diagnostic tests and evaluations, the doctor will recommend the best glaucoma treatment method for the patient.

Glaucoma, if developed once, cannot be cured or reversed. But the progression of the condition can be managed by reducing eye pressure through various treatments. The best line of treatment is often determined after a thorough diagnosis of the condition and evaluating the severity of the condition. The treatment options are mentioned below:

Eye drops for glaucoma treatment

The initial treatment for glaucoma is prescription eye drops. Commonly prescribed eye drops for glaucoma are:

• Prostaglandins- This eye drop increases the outflow of the eye fluids, thereby decreasing the intraocular pressure.
• Beta Blockers- The beta blocker eye drops work by inhibiting the production of eye fluids, which lowers the eye pressure.
• Alpha-adrenergic Agonists- These eye drops reduce the production of eye fluids and increase the outflow rate simultaneously.

Other eye drops for glaucoma include Carbonic anhydrase inhibitors, Rho kinase inhibitors, and miotic agents, which are quite beneficial.

Medicines for glaucoma treatment

Medicines for glaucoma treatment include Latanoprost (Xalatan), Travoprost (Travatan Z), Latanoprostene bunod (Vyzulta), Tafluprost (Zioptan), and Bimatoprost (Lumigan).

Surgery for glaucoma treatment

Different surgical methods for glaucoma treatment include:

• Laser Treatment for Glaucoma-  Laser treatment is recommended for patients who cannot tolerate eye drops or do not get effective results from medicines. Different approaches for laser surgery for glaucoma are:
  1. Laser trabeculoplasty-  The laser is used to open the drainage tubes in the eye, allowing more fluid to drain out.
  2. Cyclophotocoagulation- It involves using a laser to reduce the production of the aqueous humor by damaging the ciliary body.
  3. Laser iridotomy- In this technique, the laser is used to create holes in the iris that allows excess fluid to drain from the eye and reduce the eye pressure.
• Drainage Device- This technique involves placing an implant device that allows the eye fluid to drain out from the eye. The implant device is stitched to the sclera, and the tube is connected to the anterior chamber of the eye for fluid drainage.
• Filtering Surgery- Also known as trabeculectomy, this procedure involves creating an opening in the sclera (white part of the eye). The fluid exits from that space and gets absorbed by the body.
• Minimally Invasive Glaucoma Surgery (MIGS)- Also known as ab-internal canaloplasty (ABIC), this technique is used to restore the natural outflow system for the eye fluids. A microcatheter is used to enlarge the eye’s drainage system to reduce eye pressure. The microcatheter used in the procedure is designed specifically to enter the drainage canal safely. A sterile viscoelastic gel is injected into the canal to dilate it up to two or three times its original size. This allows the aqueous fluid to drain correctly.

Glaucoma surgery aims to reduce the intraocular pressure in the eyes. Although glaucoma surgery does not require strategic preparation, it is always best to prepare yourself for the surgery and know what to expect.

• Wear comfortable clothing on the day of your glaucoma surgery. It is best to wear something like a shirt that can be easily removed without moving past the eye.
• Avoid wearing jewellery, make-up, contact lenses, lotions or moisturizers on the day of surgery.
• Follow your eye surgeon’s instructions about what you can or can’t eat or drink before the glaucoma surgery. Since the surgery is performed under anesthesia, you need to get clear instructions on what to eat and what to avoid.
• Before your glaucoma surgery, let your eye surgeon know any medications or dietary supplements you use. Certain painkillers and blood thinners need to be avoided before glaucoma surgery.
• Ask an adult to accompany you to the hospital and drive you back home after the glaucoma surgery.
• Vital documents that you may need to carry to the hospital are a health insurance card, identity document, and any other additional paperwork or documents that your eye surgeon gives.

Recovery after glaucoma surgery is usually pain-free and simple. Most of the post-surgery recovery depends on the procedure and your expectations from the recovery period.

It is common for the patient to experience blurry vision in the operated eye immediately after the surgery. Other temporary side effects after glaucoma surgery are:

• redness, swelling and irritation in the eye
• a feeling that something is stuck in the eye

These side effects are not major and are likely to subside with medications and eye drops. Most people who have glaucoma surgery do not experience significant pain. If you feel pain in the eye, however, you should consult your eye doctor about the best options to relieve it.

Recovery from glaucoma surgery depends from person to person. Visual recovery in the case of minimally invasive surgeries is very short. Typically, the recovery time may range between a few days to a week. Most people can resume daily activities such as reading, watching TV or using phones, computers or other electronic devices within the first few days following surgery. Eye protection (a shield or glasses) prevents bumping or rubbing the eye for the first few days after the surgery.

Avoid the following for a couple of days after glaucoma surgery:

• Bending, straining, or lifting
• Exercises such as running, or lifting heavy weights
• Taking a bath in hot tubs or diving into a swimming pool
• Wearing eye makeup or face cream
• Wearing reusable contact lenses

When it comes to surgical intervention for advanced glaucoma cases, the benefits typically outweigh the risks. However, here are some rare risks and complications involved in glaucoma surgery:

• Vision Loss – Glaucoma surgery may temporarily disrupt your vision after your operation. But the chances of this complication are very rare.
• Bleeding – Rare complications include bleeding inside the eye, infection, and fluid pockets behind the retina due to shallow eye pressures.
• Infection – Infection inside the eye may occur after glaucoma surgery, which can be very serious and may threaten vision. These infections sometimes occur immediately after the surgery and may also occur weeks, months, or even years after the surgery.
• Low Eye Pressure – Sometimes, glaucoma surgery can lead to eye pressures that are too low, also called hypotony (fluid gets collected behind the retina). This is more common soon after the surgery.