what is Glaucoma Surgery?
At The Eye Center of Central PA, our skilled eye surgeons are proud to offer some of the safest, most effective, and proven methods of glaucoma surgery for our patients with late-stage glaucoma. We perform comprehensive eye health exams and consider everything from a patient’s medical history to his or her typical day-to-day activities to make sure we determine the best possible treatment for each case. Sometimes the ideal treatment is surgery, and our team is highly trained and experienced in some of the most advanced glaucoma surgeries available.
Two of our most frequently selected surgical options are the Kahook Dual Blade (KDB) goniotomy and the traditional trabeculectomy. Both procedures work to improve or create drainage pathways in the eye so that intraocular fluid is able to pass more freely, which lowers internal eye pressure.
who needs glaucoma surgery?
To determine whether a KDB goniotomy or trabeculectomy is the best treatment option for your glaucoma, you will need to visit The Eye Center of Central PA for a thorough consultation and assessment. Our team uses the most advanced and innovative technologies and techniques to evaluate your type and stage of glaucoma and decide if you are an ideal candidate for one of these procedures.
Generally speaking, trabeculectomies are often performed for patients with open- or closed-angle glaucoma who have not achieved relief from eye drops, medication, or MIGS procedures. Kahook Dual Blade goniotomies tend to be best for patients with mild or moderate open-angle glaucoma, though some patients with narrow-angle glaucoma may also benefit from the procedure.
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how is glaucoma surgery done?
Both the Kahook Dual Blade goniotomy and the trabeculectomy are typically performed as outpatient procedures. Most patients are very comfortable using only local anesthetic to numb the eyes; however, light sedation or general anesthetic can be requested in certain cases. Whether you visit The Eye Center of Central PA for a KDB procedure or a trabeculectomy, you will need to bring along a responsible adult to drive you home afterward.
Trabeculectomy
The trabeculectomy is considered by most ophthalmologists as the “gold standard” when it comes to surgical glaucoma treatment. To perform the trabeculectomy, your ophthalmologist will first create a very thin flap in the scleral tissue (the white area) of the eye. This flap will be folded out of the way, and then a tiny hole will be made in the eye’s wall to allow proper drainage of built-up eye fluid. The scleral flap is then folded back into place where it protects the drainage area while still allowing fluid to pass through. The excess fluid then drains just under the surface of the eye where it can be reabsorbed properly.
Kahook Dual Blade Goniotomy
The Kahook Dual Blade is a recent innovation in glaucoma surgical treatment. It is a single-use blade with a specialized design that allows your surgeon to simultaneously widen the eye’s natural drainage pathway and remove a very tiny section of the eye’s trabecular meshwork. The removal of this tissue allows added improvement to the flow of internal eye fluid. To perform the KDB goniotomy, your surgeon will make a very small incision at the edge of the cornea and use a specialized fluid to temporarily inflate the treatment area to achieve the best view for surgery. Once the area is inflated, the surgeon will carefully but quickly insert and remove the KDB.
Follow-Up
At The Eye Center of Central PA, we require all of our patients who have undergone any type of eye surgery to return for one or more follow-up appointments. Typically, your first follow-up will be the day following surgery and then further visits can be scheduled based on your healing and intraocular pressure improvements. Both KDB and trabeculectomy patients are usually prescribed eye drops to be used during the healing period. It is very important that you use these eye drops exactly as instructed and attend all of your scheduled follow-up visits.
Most KDB patients experience minimal downtime after their procedures and can get back to their usual activities in just a day or two. However, it is best to avoid rubbing the eyes and any strenuous activities for a week or so. A trabeculectomy is considered a more major surgery, and patients typically need 1 – 2 weeks of recovery before resuming work or daily routines. Trabeculectomy patients also need to wear an eye patch or other eye protection while sleeping for the first few weeks and avoid any activities that could elevate internal eye pressure, such as cardio, heavy lifting, and bending over.
Surgical Glaucoma relief
At The Eye Center of Central PA, our team of board-certified ophthalmologists has the skills and experience to provide relief for patients with all types and stages of glaucoma. If you have been unable to ease your glaucoma symptoms through medication, eye drops, and laser therapy, we encourage you to learn more about the Kahook Dual Blade and trabeculectomy procedures. Contact us today to set up your private, comprehensive evaluation.