Laser surgery (also called laser trabeculoplasty): Laser surgery helps fluid drain out of the eye. Although your eye care professional may suggest laser surgery at any time, it is often done after trying treatment with medicines. In many cases, you will need to keep taking glaucoma drugs even after laser surgery.
Laser surgery is performed in an eye care professional's office or eye clinic. Before the surgery, your eye care professional will apply drops to numb the eye.
As you sit facing the laser machine, your eye care professional will hold a special lens to your eye. A high-energy beam of light is aimed at the lens and reflected onto the meshwork inside your eye. You may see flashes of bright green or red light. The laser makes 50-100 evenly spaced burns. These burns stretch the drainage holes in the meshwork and lets fluid drain more effectively.
Your doctor will check your eye pressure shortly afterward. He or she may also give you some drops to take home for any soreness or swelling inside the eye. You will nee
d to make several follow-up visits to have your pressure monitored.
Once you have had laser surgery over the entire meshwork, further laser treatment may not help. Studies show that laser surgery is very good at getting the pressure down. But its effects sometimes wear off over time. Two years after laser surgery, the pressure increases again in more than half of all patients.
Conventional surgery: The purpose of surgery is to make a new opening for the fluid to leave the eye. Although your eye care professional may suggest it at any time, this surgery is often done after medicine and laser surgery have failed to control your pressure.
Surgery is performed in a clinic or hospital. Before the surgery, your eye care professional gives you
medicine to help you relax and then small injections around the eye to make it numb.
The eye care professional removes a small piece of tissue from the white (sclera) of the eye. This creates a new channel for fluid to drain from the eye. But surgery does not leave an open hole in the eye. The white of the eye is covered by a thin, clear tissue called the conjunctiva. The fluid flows through the new opening, under the conjunctiva, and drains from the eye.
Aqueous drains from the eye at the 'Angle' created by the inner surface of the cornea and the front surface of the iris. A fine meshwork of tissue allows the aqueous to drain into a canal that then carries the fluid out of the eye.