Glaucoma is a prolonged eye disease that can lead to blindness, affecting millions worldwide. Eye drops are the traditional mode of treatment for this condition, but recent developments in surgical procedures offer additional options that can be just as effective. These surgeries are safe, minimally invasive, and are much more common today than a decade ago.
Basics of Glaucoma
Glaucoma is a condition caused by an increase in pressure within the eye, leading to eye damage. Too much fluid produced or a lack of fluid drainage can result in increased eye pressure, which affects vision. Reducing eye pressure by medication or surgery is the basis of glaucoma treatment.
Benefits of Surgery vs. Eye-Drop Treatment
Surgical treatment options for glaucoma are invasive, and eye drops are typically preferred. However, there are specific cases in which surgery may offer more benefits than traditional eye drops.
If a patient has difficulty self-applying eye drops or needs someone else to assist them, surgery may be the better option. Also, frequent travel for work or living in a remote area can make obtaining eye drops difficult, so surgery might be a more appropriate choice.
Surgical treatment also comes into play as a supplement option if medication is not sufficiently lowering eye pressure.
Types of Laser Surgery for Glaucoma
There are several surgical procedures for treating glaucoma. These surgical options include selective laser trabeculoplasty (SLT), argon laser trabeculoplasty (ALT), laser peripheral iridotomy (LPI), and crystalline lens removal.
Selective and Argon Laser Trabeculoplasty
SLT and ALT are minimally invasive treatments used for open-angle glaucoma. Open-angle glaucoma does not have any eye structures that block fluid drainage. Eye drops are usually the first line of treatment, but some doctors opt for SLT as an initial treatment. ALT is less commonly done, but still effective.
Both SLT and ATL involve a laser-firing into the eyes’ trabecular meshwork – the drainage system. This laser causes inflammation, which initiates a healing process that opens the drain.
Laser Peripheral Iridotomy
LPI is a surgical procedure in which a laser creates a hole in the iris, allowing fluid to move from behind to the front of the eye. This process is used in narrow-angle glaucoma to prevent the iris from moving forward and blocking fluid drainage. Surgeons also use LPI as a preventative treatment if there is enough risk of developing glaucoma.
Removal of the Crystalline Lens
Removing the natural lens by cataract surgery can also be a treatment option in some cases of narrow-angle glaucoma. An artificial lens replaces the removed lens and is much thinner.
This procedure is especially beneficial if cataract surgery is already scheduled. In such cases, the procedure can also benefit progressing glaucoma by preventing angle closure from the structures of the eye pushing forward.
Summary
Advancements in the treatment of glaucoma have introduced more surgical options. These surgeries are less invasive, more effective, and offer better evidence of benefits than in years past. Diagnosed patients are encouraged to discuss glaucoma treatment options with their optometrists to determine the best course of action for their condition.
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