Dr Ahmed Al Moatasem

Lasik & Eye Surgery Center

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Glaucoma Surgery

Glaucoma is a disease characterized by the increase of pressure inside the eye. There is a small space in the front of the eye called the "anterior chamber". Clear liquid flows in-and-out of the anterior chamber. If a patient has glaucoma, the fluid does not drain properly out of the eye. The increased pressure, called intraocular pressure, can damage the optic nerve, which transmits images to the brain. If damage to the optic nerve from high eye pressure continues, glaucoma will cause permanent loss of vision. If left untreated, glaucoma can cause total permanent blindness.

There are 2 types of glaucoma:
Primary chronic open-angle glaucoma (COAG) In this case, the structures of the eye appear normal, but fluid in the eye does not flow properly through the drain of the eye. This type has no visible signs or symptoms for the patient to be noticed until the disease is at its final stages.
Angle-closure glaucoma. is less common but can cause a sudden buildup of pressure in the eye. Drainage may be poor because the angle between the iris and the cornea (where a drainage channel for the eye is located) is too narrow. Patient experiencing a sudden build-up of eye pressure may experience following signs and symptoms:
•    Seeing halos around lights
•    Vision loss
•    Redness in the eye
•    Eye that looks hazy (particularly in infants)
•    Nausea or vomiting
•    Pain in the eye
•    Narrowing of vision (tunnel vision)
How Is Glaucoma Treated?
•    Eye drops
These either reduce the formation of fluid in the front of the eye or increase its outflow. One or more types of eye drops may have to be taken up to several times a day to lower intraocular pressure.
•    Laser
Laser treatment for glaucoma slightly increases the outflow of the fluid from the eye in open-angle glaucoma or eliminates fluid blockage in angle-closure glaucoma. Types of laser surgery for glaucoma include trabeculoplasty (SLT) and YAG iridotomy,
Selective Laser Trabeculoplasty, or SLT, is used when eye drop medications are not lowering the eye pressure enough or are causing significant side effects.
Laser energy is applied to the drainage tissue in the eye. This starts a chemical and biological change in the tissue that results in better drainage of fluid through the drain and out of the eye. This eventually results in lowering of IOP. It may take 1-3 months for the results to appear.
Normally intraocular fluid flows freely between the anterior and posterior sections of the eye. As pressure builds in the eye, this circulation is cut off. If fluid cannot be drained, it may build up inside the eye and cause damage to the optic nerve. Laser peripheral iridotomy is a treatment where the surgeon uses a YAG laser to create a small hole in the peripheral iris. This improves the circulation of fluid inside the eye and widens the anterior chamber angle.
•    Surgery
Trabeculectomy is a surgical procedure recommended for patients with glaucoma that continues to progress despite use of medications and/or laser treatments and to relieve intraocular pressure by removing part of the eye's trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed. This provides an alternative method of aqueous humor filtration when the natural trabecular outflow pathway is blocked or poorly functioning. This outpatient procedure is performed under topical.
An iridectomy is a procedure in eye surgery in which the surgeon removes a small, full-thickness piece of the iris, which is the colored part of the eye. The surgeon uses a microscope and special miniature instruments to make an incision in the cornea and remove a section of the iris, usually at the 12 o'clock position. The incision in the cornea is self-sealing. These procedures are most frequently performed in the treatment of closed-angle glaucoma. It is a very effective and safe surgical procedure for glaucoma treatment.

Can Glaucoma Be Prevented?
Glaucoma cannot be prevented, but if it is diagnosed and treated early, the disease can be controlled. Loss of vision caused by glaucoma is irreversible and cannot be restored. However, successfully lowering eye pressure can help prevent further visual loss from glaucoma. Most people with glaucoma do not go blind as long as they follow their treatment plan and have regular eye exams.

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