Glaucoma with high IOP probably brings high risk of womens vision loss, so that early detection and treatments including glaucoma surgery are important. Currently, both laser and non-laser glaucoma surgeries aim at either decreasing the production of internal eye fluids or increasing the outflow of them. These surgeries can remove the high IOP and stabilize normal IOP, thus optic nerve is also under protection.
In fact, surgery is not the only treatment for glaucoma. There are also some medications can control the development of glaucoma, such as topical eye medications and oral medications. However, some glaucoma patients do need a surgery to improve the drainage of their eye fluids. There are several glaucoma surgeries that are proved effective: selective laser trabeculoplasty (SLT), trabeculectomy and other variations.
Laser trabeculoplasty is performed by using a laser to create tiny holes in the filtration angle so that the outflow of eye fluids can be increased. And a SLT creates minimal heat damage to adjacent tissue, which is an adjunct to the patient's ongoing eye drops. The study of SLT treatment for open-angle glaucoma is on the way.
The non-laser surgery trabeculectomy performs in another way. This procedure involves partial removal of the eye's drainage system. Trabeculectomy can deal with severe glaucoma that is beyond ordinary eye drops, pills and laser trabeculoplasties by making a surgical incision into the eye's drainage system and creating new channels for fluids flow.
Trabeculectomy also involves small plastic devices including shunts and implants, whose tiny tubes will be inserted into the holes created in the surgery. Offering a direct passageway, these tubes divert eye fluids to bypass the eye's damaged drainage channel. These shunts are most made with silicone or polypropylene. They can be made with or without valves for drainage control. Complications of applying these devices also exist, such as too low IOP, mal-positioned implants and tube erosion.
There are also some new types of shunts that are either recently approved or in clinical trials. Reports show that they are safer, even if more complex. Ex-PRESS Mini Glaucoma Shunt and DeepLight Glaucoma Treatment System are two of those types.
Similar variations of trabeculectomy include trabeculotomy without tissue removal and goniotomy for infants and children. Surgeries involve iris treatment include iridotomy and iridectomy. The first type creates a hole in the iris to remove iris blockage and the latter type removes a small piece of iris.
By altering the eye's drainage channels, minimal penetration surgeries can also improve the flow of fluids. These surgeries only create superficial incisions and are less likely to cause complications. Examples of them include a deep sclerectomy that invades the sclera and a viscocanalostomy involves viscoelastic.
There are still different opinions about the application of glaucoma surgeries. Some experts argue that glaucoma surgeries are far more expensive than long-term drug treatments.
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