Glaucoma is a chronic, gradual degeneration of the optic nerve fibres in the back of the eye, which transmit visual impulses from the retina to the brain. Glaucoma is often caused or exacerbated by intraocular pressure within the eye that is too high for the nerve’s sustained health.
Depending on the severity of the condition, glaucoma therapy may include surgery, laser treatment, or medication. Glaucoma damage is persistent and seems to be irreversible, although it may be treated with drugs and surgical procedures.
It is a less risky and often recommended alternative for glaucoma surgery. It is a wise decision to consider minimally invasive glaucoma surgery (MIGS) before undergoing regular glaucoma surgery such as trabeculectomy or Iridotomy with significant complications. MIGS serves to efficiently reduce eye pressure and prevent the progression of glaucoma or future eye injury, and it has less side effects and consequences.
MIGS surgery uses microscopic-sized equipment and small incisions to improve the outflow of fluid (aqueous humour) from the eye. The trabecular meshwork prevents normal aqueous fluid drainage. The trabecular meshwork is a layer of tissue at the base of the cornea that is responsible for aqueous humour outflow from the eye. When it becomes blocked, the ocular pressure rises to alarming levels.
MIGS techniques aid in addressing rising pressure by lowering ocular pressure by developing a new path through or around the trabecular meshwork. Tiny devices are put in the aqueous humour to help the aqueous humour drain more easily from the eyes.
MIGS procedures are classified into many categories, which include:
- Internal trabecular bypass surgery
- Laser treatments
Micro Trabeculectomy procedure includes inserting very microscopic-sized tubes into the drainage angle to allow aqueous fluid from the anterior chamber of the eyes to drain. The Xen Gel Stent and PRESERFLO Microshunt are two new products that can make trabeculectomy operations easier.
Selective laser trabeculoplasty (SLT) for laser glaucoma surgery is one of the most recent surgical therapies for open-angle glaucoma that may lower the number of eye drops a person has to take on a daily basis to manage glaucoma. A laser is used in this treatment to produce microscopic holes that enable eye fluid to flow quickly, decreasing eye pressure. Laser glaucoma surgery has a 10% success rate among patients and reduces ocular pressure by 20% to 30%.
It is one of the most common glaucoma procedures, utilised for a large drop in intraocular pressure, which aids in the treatment of glaucoma. Trabeculectomy is the removal of a portion of the trabecular meshwork to aid in the outflow of aqueous fluid.
An incision is created at the outer intersection of the cornea and sclera, and a part of the conjunctiva that covers the sclera is pushed back, creating a flap in the sclera. In the palace, the scalp flap is reattached and small nylon sutures are used to form an adjustable drainage valve.
Trabeculectomy is performed on the top part of the eye (under the eyelid), so the bleeding and incisions are not apparent to others.
A laser is used to generate a tiny in the peripheral aris to control the outflow of aqueous humour via it in the rarest kind of glaucoma known as narrow-angle glaucoma. This is known as an iridotomy or peripheral laser iridotomy. Iridectomy, on the other hand, is removing a section of the iris to create a larger drainage hole.
This surgical method helps to lessen the chance of narrow-angle glaucoma progressing to acute angle-closure glaucoma, a life-threatening disease that causes IOP to rise quickly. Acute angle closure is exceedingly difficult to manage and need rapid medical care to avoid vision loss.
- Eyesight Loss – Glaucoma surgery may temporarily impair your vision after the procedure.
- Bleeding – Uncommon or unusual consequences include bleeding within the eye, infection, and fluid pockets behind the retina caused by very low eye pressures, all of which should be treated immediately.
- Infection – Infection within the eye may develop on extremely rare instances, despite medication, and may be quite dangerous, threatening eyesight for weeks, months, or even years following surgery.
- Low Ocular Pressure – Occasionally, surgery might result in temporary eye pressures that are excessively low, a condition known as hypotony. This is more prevalent immediately after surgery, resulting in a shadow in your peripheral or side vision.
- Scarring – Due to the inherent scarring tendencies of the eye, certain procedures may fail over time, resulting in increased ocular pressures.
- Cataract – Cataract development is likely to be exacerbated by glaucoma surgery, however cataracts are quite simple to treat surgically.