Glaucoma Surgery in Michigan

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What is glaucoma and how can it be treated?

Glaucoma treatment involves increasing aqueous humor outflow or decreasing aqueous humor production, resulting in the lowering of the intraocular pressure (IOP) to help prevent damage to the optic nerve within the eye. The three main types of treatment to lower the IOP are medical therapy, laser treatment, and surgery. In regard to glaucoma surgery, there are traditional options such as trabeculectomy and tube shunts as well as a set of less invasive procedures classified as Micro-Invasive Glaucoma Procedures (MIGS for short). Some such as ECP have been done routinely for many years at Glaucoma Center of Michigan, others have been developed more recently. You can read more about these options below.

Medical treatment consists mainly of drugs that are delivered to the eye by drops. Eye drops have the advantage of delivering the highest possible dose of medication directly to the eye while minimizing any side effects to the rest of the body. Pressure within the eye is determined by the balance between the amount of fluid that the eye produces and the rate at which it drains through the trabecular meshwork. Medications either reduce the production of fluid (affecting inflow) or increase the rate at which fluid drains (outflow). There are many different drops that can be used in various combinations and your doctor will work with you to determine what is optimal for your situation.

Lasers are used frequently for glaucoma treatment, with common types including the Selective Laser Trabeculoplasty (SLT), Laser Peripheral Iridectomy (LPI), Micropulse® Diode Cyclophotocoagulation (MP3) and traditional Trans-Scleral Cyclophotocoagulation Diode Laser (TSCPC). SLT laser improves the outflow of fluid, thus lowering the IOP. LPI is done to help reduce narrowing of the anterior angle to help the aqueous fluid have better access to the trabecular meshwork drainage system. MP3® and TSCPC lasers are externally applied and work by decreasing the amount of intraocular fluid (aqueous humor) produced within your eye to lower the IOP; TSCPC is generally utilized for more advanced glaucoma. Some patients have laser treatment as their primary method of controlling their glaucoma while others have this done in combination with eye drops. Laser treatment is performed in the office (SLT or LPI) or the operating suite (MP3® and TSCPC) and generally allows a rapid return to normal daily activities.

Surgery for glaucoma is performed in the operating room and is done to increase aqueous fluid outflow and lower eye pressure. These surgeries are done as an outpatient and are typically performed when medical or laser treatment has not adequately controlled a patient's pressures although sometimes can be done as a primary treatment. Common procedures include traditional surgery such as trabeculectomy, Ex-Press® shunts and glaucoma drainage devices (tube shunts) as well as a group of surgeries collectively known as Micro-Invasive Glaucoma Surgery or MIGS. These are a group of procedures designed to lower IOP with a less invasive approach than traditional surgeries. Each patient is unique, and your doctor will discuss with you which procedure has the highest possible success rate with the least chance of complications for your particular glaucoma problem.

For more information on specific procedures please click below:

Micro-Invasive Glaucoma Surgery

Traditional Glaucoma Surgery

If you have additional questions, please do not hesitate to call The Glaucoma Center of Michigan at (248) 356-0098.

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