Also see section on Glaucoma under Eye Conditions. 

Eye drops or laser treatment (see Glaucoma: non-surgical treatment) may fail to lower the eye pressure enough and your surgeon may recommend surgery as the next step. There are a number of procedures that can be offered:

Cataract surgery alone: this approach is useful in patients who have mild to moderate glaucoma and who have a significant cataract (clouding of the lens). It is particularly useful in patients who are long sighted (hypermetropic) because it removes the risk of acute glaucoma. It is vey safe and the recovery is fast, but the level of pressure reduction is usually very small. For more information, please see the cataract surgery section

Cataract surgery with iStent: the addition of an iStent at the time of cataract surgery can improve pressure control in patients with glaucoma and the additional risk to the patient is very low. The main issues are that some patients get bleeding in the eye after this procedure. Recovery is fast, even if a bleed occurs, but the pressure reduction is only slightly better than cataract surgery alone so this approach is not suited to patients with severe glaucoma. See the picture below: this stent is extremely small and it is on the inside of the eye so patients never feel any foreign body sensation from the stent. For more information please see the manufacturer's website: Glaucos iStent


G2 on finger small

Formal glaucoma surgery (Trabeculectomy): this approach is recommended for patients with severe glaucoma when medical and laser treatments have been insufficient. This is still a day procedure but it has a slower recovery and some patients take over one month to get back to normal function. 

Trabeculectomy and cataract surgery as one procedure: both operations can be performed on the same day if required. This is generally reserved for patients who have advanced cataract and advanced glaucoma. Visual recovery is relatively slow, as with standard Trabeculectomy surgery and other procedures may later be required to achieve an adequate reduction in eye pressure. 



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