Laser treatment can be as effective as drops in lowering the IOP. It is a good alternative to drops in some patients.
Surgical treatments include trabeculectomy, glaucoma drainage devices or ‘Phaco +’ procedures. The latter is undertaken along with a glaucoma micro stent or laser treatment inside the eye. Trabeculectomy surgery is the common glaucoma operation performed worldwide. The specialist creates a new pathway for fluid to drain away from the eye using the patient’s own tissue. A glaucoma drainage device is used in complex cases. The specialist will insert a small silicone tube into the front chamber of the eye. This tube is attached to a drainage plate. This will allow the fluid to drain away via this implant.
Selective laser trabeculoplasty (SLT) can reduce the IOP by 20-30%. Just as much as an eye drop in patients who respond well to the treatment. This can mean that laser alone will be enough to control the IOP without the need for daily drops for 3-5 years. SLT is painless and can be done in the clinic. The laser modifies the normal physiological drainage pathway within the eyeball. Furthermore, it encourages it to drain the aqueous fluid in a more effective way. It does not damage the eye. The treatment is a safe and well-tolerated. This treatment is especially suitable for patients who cannot put drops in.
This treatment is also used for those who cannot tolerate some of the side effects of glaucoma drops.
Regular lifelong follow-up is crucial in monitoring glaucoma and the effect of treatment. You will not be aware if your glaucoma is getting worse until the disease is in its end stage. This will limit the treatment options. Eye pressure checks, optic disc scans and visual field tests are the gold standard follow-up tests for all glaucoma patients.