Glaucoma is a chronic eye condition that causes gradual vision loss due to irreversible damage of optic nerve; caused by increased intraocular pressure. Glaucoma if not treated will continue to damage optic nerve fibers, which transmit images to the brain, and will lead to loss of vision causing permanent blindness. The treatment of glaucoma aims at lowering intraocular pressure to prevent/slow optic nerve damage.
Generally, the first line of treatment for glaucoma is medications followed by laser and other surgical procedures if glaucoma is not controlled with conservative treatment. Surgery involves a laser or incisional surgery and usually laser surgery is recommended prior to incisional surgery as laser is less invasive. In laser, a focused light beam is used to release intraocular pressure by treating trabecular meshwork. Various laser surgeries used to treat glaucoma are selective laser trabeculoplasty (SLT), argon laser trabeculoplasty (ALT), laser peripheral iridotomy (LPI) and laser cyclophotocoagulation. In incisional surgery (filtering surgery), an artificial drainage hole is created in sclera with procedures such as trabeculectomy or sclerostomy to release intraocular pressure. There are also newer procedures known as minimally invasive glaucoma surgery (MIGS) that hold promise at treating glaucoma.
What Are The Side Effects Of Glaucoma Surgery?
Glaucoma surgery has proven to successfully slow glaucoma progression by lowering the intraocular pressure. However, the damage that has already been done to optic nerve cannot be reversed with glaucoma surgeries. In addition, if glaucoma is not treated appropriately, it will surely progress to vision loss. Although, there are rare side effects of glaucoma surgery, but the possible side effects that a patient might have include loss of vision, infection, sensitivity to light, long term inflammation/irritation of the eye, bleeding, low eye pressure, scarring, cataract and/or need for more surgery.
Loss of Vision: There is temporary loss of vision after glaucoma surgery, but on rare occasions permanent vision can be completely lost after glaucoma surgery.
Nevertheless, the permanent loss of vision is a very rare side effect and usually patients benefit from glaucoma surgery.
Infection: Antibiotics are given prophylactically before and after the surgery along with complete maintenance of sterilization during the surgery to prevent any infection. However, even after these precautions, some patients might develop infection that might lead to vision loss, therefore, signs of infection such as pain, eye redness and/or excessive tearing should be reported to ophthalmologist and needed antibiotic treatment should be taken to avoid any serious damage to the eye.
Bleeding: This is a rare complication and use of blood thinners should be discussed with ophthalmologist prior to the surgery if the patient is on anticoagulants.
Scarring: Glaucoma surgeries may fail in the long run due to scarring or natural healing of the eye, which leads to increased intraocular pressure. This might require restarting medications or need for repeat surgery.
Lower Eye Pressure: On occasions, glaucoma surgery leads to lower eye pressure known as hypotony. This is a temporary effect soon after surgery that might cause peripheral visual changes. The intended pressure is achieved after some time, but on occasions hypotony persists that requires another surgery to correct it.
Cataract: It is precipitated with glaucoma surgery, but cataract can be fixed easily by surgery. It depends on the ophthalmologist whether to treat glaucoma and cataract at the same time and depends on the impact it is causing on vision.
There are certain risk factors for developing complications after glaucoma surgery, which include obesity, diabetes, high blood pressure, smoking, bleeding disorders, infections, and heart and lung diseases.
After glaucoma surgery if a patient experiences sudden/severe eye pain, loss of vision or other visual changes, signs of infection (fever/chills), nausea, vomiting, redness, swelling, abnormal eye discharge, excessive bleeding, cough, shortness of breath and/or chest pain, then the patient should immediately contact the doctor.
Although, a patient may sometimes experience the above side effects, which are rare, but most of the times the surgery is successful in reducing intraocular pressure and slowing glaucoma progression, thus preventing permanent blindness.