There are many types of glaucoma surgery available and which type to use depends on severity of the glaucoma and the eye pressure. If medication is unable to control the eye pressure, your doctor will usually recommend laser or incision surgery to lower the pressure.

Glaucoma laser surgery tries to open up the meshwork at the angle to allow more fluid to exit, leading to lower eye pressure. Different types of lasers allow for better results and opportunities for re-treating the angle.

Normal eye and Laser treatment to the angle

The most common type of incision glaucoma surgery is called a trabeculectomy. This surgery creates an opening which allows fluid to flow out of the eye. There are variations to the trabeculectomy but each variation will lower the pressure by proving an alternative pathway for the fluid to exit the eye.

Trabeculectomy lowers the pressure by allowing fluid to escape through a new opening

In more complicated glaucoma or in eyes with previous intraocular surgery, failed trabeculectomy, young patients or eyes with significant scarring, a drainage device is used. These devices are known as shunts or tube glaucoma implants (see diagram below), and are designed to maintain an artificial drainage pathway in eyes with uncontrolled glaucoma.

There are other more unusual types of glaucoma surgery available to help control the intraocular pressure. Your eye doctor or glaucoma specialist will be able to discuss all the options and plans available to help you control the pressure. All glaucoma surgery has risks and complications. It is much different than cataract surgery where much of the risk occurs early in the post-op period. Glaucoma surgical risks occur early and late and it is important that all patients discuss all the risk and benefits associated with any type of glaucoma surgery.