Selective laser trabeculoplasty is a laser treatment used to help reduce intraocular pressure in open-angle glaucoma. It targets the eye’s natural fluid drainage channels and aims to improve aqueous outflow. In suitable patients, it may be used either as an alternative to eye-drop therapy or as an adjunct treatment. The procedure is performed at the slit-lamp microscope in the examination room.
Argon laser peripheral iridotomy is a laser procedure performed especially in eyes with narrow angles or a risk of angle closure. By creating a very small opening in the iris, it allows better fluid circulation and reduces the risk of sudden pressure spikes. The decision is made after detailed evaluation of the anterior chamber angle using examination and imaging. It is performed at the slit-lamp microscope.
Microinvasive glaucoma surgeries are modern procedures designed to lower intraocular pressure using smaller incisions compared to conventional surgeries. They aim to enhance aqueous outflow or bypass areas of resistance. Patient selection depends on glaucoma type, stage, and the presence of cataract.
GATT is a modern glaucoma procedure that reduces outflow resistance by accessing the eye’s natural drainage canal from within. It does not require an external incision and may improve fluid drainage effectively. It is mainly used in selected cases of open-angle glaucoma and some childhood glaucoma cases. Its main advantage is 360-degree trabecular treatment, with higher success rates compared to some other MIGS procedures.
KDB surgery is a minimally invasive procedure that removes part of the trabecular meshwork using a specialized microsurgical blade. The goal is to improve the natural outflow pathway and reduce intraocular pressure. It can be performed alone or combined with cataract surgery. One advantage is a lower risk of intraocular bleeding.
XEN implant surgery involves placing a very small gel-like implant to regulate aqueous outflow. It is used in selected glaucoma patients when medications or laser treatments are not sufficient. Its superiority over traditional glaucoma surgery has not been clearly demonstrated.
Trabeculectomy is a classic glaucoma surgery that creates a new drainage pathway to lower intraocular pressure. It remains an important option in advanced glaucoma or when adequate pressure control cannot be achieved with other treatments.
This procedure uses a tube-and-plate system to drain intraocular fluid in a controlled manner. It is typically used in refractory, previously operated, or complex glaucoma cases. The goal is to achieve safer intraocular pressure levels and protect the optic nerve.
The Ahmed glaucoma valve is a valved drainage implant that helps regulate intraocular pressure. It is commonly used in difficult-to-control glaucoma cases, especially secondary glaucoma associated with diabetes.
The Paul glaucoma implant is a modern drainage device used in refractory glaucoma cases. Its thin tube design allows controlled fluid drainage with minimal long-term corneal damage. The choice of implant depends on eye anatomy, glaucoma type, and previous treatments.
Micropulse transscleral diode laser is a non-incisional laser treatment that reduces aqueous humor production. It is used as an alternative or adjunct in selected refractory glaucoma cases. Compared to conventional diode laser, it has fewer side effects and can be used in patients who cannot undergo surgery.
Complex glaucoma surgeries are customized procedures for patients with additional risk factors such as previous eye surgery, trauma, uveitis, congenital disorders, or advanced glaucoma. Treatment is individualized according to ocular anatomy and disease progression.
In patients with both cataract and glaucoma, both conditions can be treated in a single surgical plan when appropriate. Combining procedures aims to improve visual outcomes and better control intraocular pressure. The surgical strategy depends on disease stage and target pressure.
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