When medicines and laser surgeries do not lower eye pressure effectively, doctors may advise a procedure called filtering microsurgery (sometimes called traditional or cutting surgery).
In filtering microsurgery, a tiny drain hole is made in the sclera (the white part of the eye) in a treatment called a trabeculectomy or a sclerostomy. The new drainage hole allows fluid to drain of the eye and assists lower eye pressure. This prevents or decreases damage to the optic nerve.
Is There Pain During the Glaucoma Surgery?
In many cases, there is no pain involved during the glaucoma surgery. The surgery is typically done with a local anesthetic and relaxing medications. Typically a minimal kind of anesthesia, called intravenous (I.V.) sedation, is utilized.
In addition, an injection is provided around or behind the eye to avoid eye movement. This injection is not painful when I.V. sedation is used first. The patient will be unwinded and sleepy and will not experience any pain during surgery.
The majority of the associated research studies document follow-up for a one year duration. In those files, it reveals that in older patients, glaucoma filtering surgery achieves success in about 70-90 % of cases, for a minimum of one year.
Sometimes, the surgically-created drainage hole begins to close and the pressure increases again. This occurs since the body attempts to recover the brand-new opening in the eye, as if the opening were an injury. This quick healing occurs most often in more youthful people, since they have a stronger healing system. Anti-wound healing drugs, such as mitomycin-C and 5-FU, aid slow down the healing of the opening. If needed, glaucoma filtering surgery can be acted of times in the exact same eye.
Usually, filtering surgery is an outpatient treatment, requiring no overnight medical facility stay. Within a couple of days after surgery, the eye doctor will need to look at the eye pressure. The doctor will likewise try to find any signs of infection or boost in inflammation.
Recovery Time after Glaucoma Surgery
For at least one week after surgery, patients are recommended to keep water from the eye. The majority of day-to-day activities can be done, nevertheless, it is important to prevent driving, reading, flexing, and doing any heavy lifting.
Each case is various, so contact your doctor for specific suggestions.
Appearance of the Eye after Surgery
The eye will be red and irritated shortly after surgery, and there might be increased eye tearing or watering during recovery period. The inner eye fluid streams through the surgically-created hole and forms a small blister-like bump called a bleb. The bleb, generally located on the upper surface of the eye, is covered by the eyelid, and is usually not visible.
Changes in Vision and Medication
There might be some vision changes, such as blurred vision, for about 6 weeks after the surgery. After that time, vision will typically return to the exact same level it was prior to surgery.
Vision can sometimes enhance after surgery in patients who had actually been using pilocarpine. After stopping pilocarpine drops, the pupil go back to normal size, allowing more light to go into the eye.
In a couple of cases, the vision may be worse due to extremely low pressure. Cataracts or wrinkle in the macula area of the eye might establish.
After surgery, you might have to change your contact lenses or glasses. Gas permeable or soft contact lenses might be used. However, the bleb may cause fitting problems, and special care will be had to avoid infection of the bleb. Contact lens users must discuss these issues with their eye doctor following surgery.