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Last Updated on January 25, 2024 by Shabnam Sengupta
When choosing which surgery is best, doctors think about what is good and not so good about each option. They consider how sick the person is, what stage the eye problem is at, and the individual’s treatment preferences. A doctor figures out these options to decide on the best surgery. Such personalised decisions not only aim at effectively controlling glaucoma but also aspire to enhance the patient’s overall quality of life. In this article, we will discuss different types of glaucoma surgeries.
What are different surgical options available?
Different types of glaucoma and their treatment exist which can be invasive and non-invasive. The surgical options for treating glaucoma have been a preferred option as it shows better results. The choice of surgery often depends on the severity of the condition, the patient’s overall health, and the specific characteristics of the type of glaucoma they are suffering from. Some of the available types of glaucoma surgery are discussed below:
Trabeculectomy
Trabeculectomy is a surgical procedure, which doctors often recommend for advanced cases of glaucoma. It involves creating a new drainage pathway within the eye to alleviate intraocular pressure. This procedure aims to lower eye pressure effectively; however, it comes with potential complications. There is a risk of infection or the development of cataracts post-surgery, which requires vigilant post-operative care. Doctors typically consider trabeculectomy when other treatments have not sufficiently controlled the condition.
Minimally invasive glaucoma surgery (MIGS)
Minimally invasive glaucoma surgery (MIGS) procedures are for individuals in the early to moderate stages of glaucoma. These surgeries focus on reducing eye pressure with minimal disruption to eye tissues. Compared to more invasive options like trabeculectomy, MIGS is renowned for its swifter recovery time and fewer complications. Its emphasis on safety and lower risk makes it a preferred choice for certain glaucoma cases.
Glaucoma drainage devices (GDD)
Doctors often consider glaucoma drainage devices (GDD) in situations where trabeculectomy has not been successful or in complex glaucoma scenarios. These devices aid in draining aqueous humour from the eye, consequently reducing intraocular pressure. However, their implantation involves potential risks. Therefore, patients should be aware of the possibilities and considerations of this procedure. GDDs are usually reserved for specific cases due to their nature and potential complications.
Cyclophotocoagulation
Cyclophotocoagulation is a surgical intervention that employs a laser to reduce the production of fluid within the eye. This procedure aims to decrease intraocular pressure by targeting the cells that produce the eye’s fluid. It is an alternative option for certain cases where other surgical interventions may not be suitable or effective.
Which surgical alternative is better for whom?
The selection of the most suitable surgical option for glaucoma should consider various factors, including the stage of the disease, patient preferences, safety profiles, and effectiveness in lowering intraocular pressure. Cyclophotocoagulation, alongside trabeculectomy, MIGS, and GDDs, presents itself as a viable option for patients. In the answer below the situations when one option can be better than the other one.
Effectiveness: Trabeculectomy has historically demonstrated effectiveness in reducing pressure and now carries a low risk of complications. MIGS procedures are less invasive and pose fewer risks, while GDDs are reserved for challenging cases. Cyclophotocoagulation is considered for individuals who do not need or may not be suitable candidates for other surgeries due to its less invasive nature.
Safety Profile: MIGS typically offers a superior safety profile, making it a preferred option for patients intolerant to higher-risk surgeries like trabeculectomy or GDD implantation. While GDDs are reserved for challenging cases.
CPC Safety: Cyclophotocoagulation, being a minimally invasive procedure, also tends to have a favourable safety profile. However, it may not be as effective in lowering eye pressure in some cases compared to more traditional surgeries.
Recovery and Post-op Care: MIGS procedures often involve shorter recovery times and demand minimal post-operative care compared to trabeculectomy or GDD implantation, which may require more vigilance.
CPC Recovery: Cyclophotocoagulation generally requires less extensive post-operative care compared to trabeculectomy or tube shunt surgery but might need multiple sessions for optimal pressure reduction.
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