Glaucoma is a progressive disease of the optic nerve that is often associated with elevated intraocular pressure. The only risk factor that can be modified to treat glaucoma is the eye pressure. Through medications, the eye pressure is lowered, reducing the likelihood of further nerve damage and vision loss. There are times that despite maximal medical therapy, the eye pressure is not low enough to prevent additional damage. Also, the medications may cause various degrees of unacceptable local and systemic side effects. In these above situations, surgery is offered as a means to lower the eye pressure.
Selective laser trabeculoplasty (SLT) uses short pulses of low energy laser light to selectively target the pigmented trabecular meshwork cells in the angle of the eye. The objective of this surgery is to help fluid drain out of the eye, reducing intraocular pressure that can cause damage to the optic nerve and contribute to loss of vision. SLT is an in-office procedure. SLT involves placing topical anesthetic eye, followed by a special contact lens. The procedure itself takes less than 5 minutes.
In trabeculectomy, a partial-thickness flap is created in the eye wall, as a means to lower the eye pressure. To prevent the body’s natural healing process from scarring this opening, anti-scarring medication (mitomycin-C) is applied to the surgical site at the time of surgery. Additional anti-scarring medication may need to be injected post-operatively to increase the likelihood of success.
In glaucoma drainage device implantation, a tube is placed in either the anterior chamber or posterior segment of the eye to allow aqueous humor to drain externally, lowering the eye pressure. The tube is attached to a plastic plate that is secured to the eye wall. Some devices have an internal valve that can regulate pressure. A patch graft is placed over the tube to reduce the likelihood of erosion and exposure of the surgical site. It may take 6-8 weeks before the implant becomes fully functional.
Dr. Joson has chosen to specialize in this particularl area and has completed additional training. He has presented and published scientific research in the basic and clinical science of glaucoma. Trust your vision to an expert in glaucoma care and treatment.