Glaucoma Surgery

Glaucoma surgery refers to many different types of procedures. Most glaucoma specialists reserve the term "surgery"f or a procedure that is done in the operating room. Like all treatments, the goal of glaucoma surgery is to LOWER EYE PRESSURE and slow down disease progression. It will not reverse any vision loss that has already occurred.

MINIMALLY INVASIVE GLAUCOMA SURGERY (MIGS)

iSTENT

The iStent® is a microstent inserted into the trabecular meshwork ("DRAIN OF THE EYE") to help lower eye pressure.

Dr. Gupta believes this procedure works best in mild glaucoma. She does it most often done at the time of cataract surgery. However, in 2022 it received FDA approval to be performed as a standalone surgery.

It is made of titanium and is MRI-safe.

OMNI

The OMNI® surgical system is a surgical procedure that opens up the trabecular meshwork ("DRAIN OF THE EYE") to help lower eye pressure.

Dr. Gupta believes this procedure is effective in all stages of glaucoma (mid to severe). She performs this surgery most often with cataract surgery but it is also FDA approved to be done on its own in place of filtering surgery.

Depending on your situation, Dr. Gupta may choose to combine this procedure with the iStent® or Hydrus® microstent.

hydrus

The HYDRUS® microstent is inserted into the trabecular meshwork ("DRAIN OF THE EYE") to help lower eye pressure at the time of cataract surgery.

Dr. Gupta believes it works best in mild/moderate glaucoma. In advanced glaucoma, Dr. Gupta will often combine the Hydrus stent with the OMNI®.

It is made of a nickel and titanium alloy

and is MRI-safe.

FILTERING SURGERY

TRABECULECTOMY

"Traditional" glaucoma surgery typically performed in advanced glaucoma or rapidly progressing glaucoma when eye drops are not enough in lowering eye pressure.

The surgery involves creating a a flap or "trapdoor" through which fluid from the front of the eye bypasses the natural drain of the eye to lower pressure.

Follow up appointments after a trabeculectomy are typically every week for the first 6-8 weeks.

TUBE SHUNT

A glaucoma tube shunt involves inserting a new drainage device into the eye to lower eye pressure. A silicone tube is placed into the front of the eye through which fluid drains before leaving the eye through a plate which is secured on the sclera (white part of the eye).

There are different types of tube shunts depending on the type and extent of glaucoma someone has.

The tube is typically covered with a patch to prevent exposure and erosion through the tissues.

XEN® gel stent is a flexible stent that is inserted into the eye. Fluid drains through the stent and accumulates in the subconjunctival space (the white part of the eye). The end result is similar to a trabeculectomy, but tends to have less risks associated with the actual surgery.

In the setting of advanced glaucoma, however, a trabeculectomy may still be preferred since it is able to produce eye pressures in the single digits, which may be required.

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MORE ABOUT GLAUCOMA

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