Glaucoma post surgery patient

Glaucoma Surgery

Glaucoma surgery may be necessary to control eye pressure better and prevent further optic nerve damage.

Glaucoma MIGS evaluation with OD.

Glaucoma and Surgical Options

Glaucoma is a group of eye diseases characterized by damage to the optic nerve, often associated with elevated intraocular pressure (IOP). Over time, glaucoma can cause irreversible vision loss or blindness if untreated. Although medication and laser treatments are often first-line therapies, surgery becomes an option when these are insufficient. The aim is not to restore lost vision, but to slow or halt further damage.

Why and When Is Glaucoma Surgery Recommended?

The Goal of Surgery

The primary aim is to lower intraocular pressure (IOP) by either improving fluid drainage or reducing its production. Surgery is considered when eye drops, oral medications, or laser treatments are unable to control IOP sufficiently, or when disease progression threatens vision despite those measures. In some cases, surgery can reduce dependency on medications such as eye drops.

Timing and Decision Factors

The decision to proceed with surgery depends on the type and severity of glaucoma, how the eye is responding to treatments, the health of ocular tissues, and patient-specific factors (age, comorbidities, lifestyle). Additionally, the potential risks and benefits must be carefully weighed; surgery is not without complications.

Glaucoma Treatment Options & Preventative Care

iDose

A micro-implant that makes a big impact. iDose TR continuously delivers glaucoma medication inside your eye. No daily drops needed!

  • One-time, in-office procedure
  • Long-term pressure control
  • FDA-approved and backed by clinical studies
  • Ideal for patients with early to moderate glaucoma
SLT (Selective Laser Trabeculoplasty)

A quick laser procedure—no meds, no recovery. SLT improves your eye’s natural fluid drainage, helping lower pressure effectively.

  • Drop-free pressure control
  • In-office procedure
  • Safe to repeat over time
  • Often used as a first-line treatment

SLT Treatment

Differentially Selective Laser Trabeculoplasty (DSLT)

DSLT is a contact-free version of SLT, offering all the same benefits without touching the eye’s surface.

  • Non-contact, non-invasive
  • Ideal for patients sensitive to traditional procedures
  • Just minutes to perform

DSLT Treatment

MIGS (Minimally Invasive Glaucoma Surgery)

MIGS procedures use tiny devices to improve drainage and reduce pressure, often done during cataract surgery.

  • Minimally invasive
  • Short recovery time
  • Reduces or eliminates the need for drops
  • Great for mild to moderate glaucoma

MIGS Treatment

Glaucoma Pre surgery patient

When to Consider Surgery in Arizona

  1. If your glaucoma is progressing despite maximal tolerated medical and laser therapy
  2. If there’s intolerance or side effects from multiple eye drops
  3. If your optic nerve damage is significant and you need aggressive pressure lowering
  4. If combining glaucoma surgery with cataract surgery is beneficial (often possible with MIGS)
  5. After evaluating risks particular to your ocular anatomy, systemic health, and lifestyle

Preparing for Surgery & What to Expect

Preoperative Steps

  1. A complete eye exam, imaging, and diagnostic testing to assess optic nerve, drainage angle, and ocular anatomy.
  2. Review your full medical history, including systemic diseases (e.g. diabetes, hypertension), medications (especially blood thinners), and lifestyle factors.
  3. You may need to stop certain medications (NSAIDs, aspirin, anticoagulants) before surgery to reduce bleeding risk.
  4. Arrange for a driver post-surgery, as sedatives or anesthesia may impair your ability to drive.
  5. You may need to fast (no food or drink) for several hours prior to surgery, depending on anesthesia.

During Surgery

  1. Laser treatments are often done in the physician’s office under topical anesthesia.
  2. Incisional, MIGS, and tube shunt surgeries typically occur in an operating room, under local anesthesia, sedation, or sometimes general anesthesia.
  3. The surgery duration depends on the procedure type: many laser procedures take minutes, whereas incisional surgeries may take up to an hour.

Postoperative Care and Recovery

  1. After surgery, you’ll likely receive eye drops (antibiotic, steroid, IOP-lowering) to prevent infection, inflammation, and manage pressure.
  2. Eye patching or shield use may be necessary temporarily.
  3. Limit certain activities for weeks: avoid heavy lifting, straining, bending over, or vigorous exercise.
  4. Avoid rubbing your eye, swimming, or environments that could expose your eye to water or contaminants until cleared by your surgeon.
  5. Frequent follow-up appointments are critical to monitor IOP, healing, and any complications.

Recovery Timelines Vary:

  1. For less invasive (laser or MIGS) procedures, many patients resume normal activities within days.
  2. For incisional and shunt surgeries, recovery may require weeks to a month of careful management.

You should contact your surgeon immediately if you experience sudden worsening pain, loss of vision, excessive redness or discharge, or other concerning symptoms.

A close-up photo of an ophthalmologist in a white coat speaking with an older patient in a well-lit clinic about glaucoma causes and types. Expert glaucoma treatment in Arizona starts with early diagnosis and personalized care from trusted eye specialists.

Success Rates and Longevity

Studies indicate that trabeculectomy lowers eye pressure in approximately 70% (7 out of 10) of patients. However, success can diminish over time due to scarring and closure of drainage pathways. It’s not uncommon for glaucoma surgery to require retreatment or additional surgeries years later. The balance between effectiveness and safety is key—some patients accept a less dramatic IOP reduction with MIGS in exchange for a lower complication rate and faster recovery.

Glaucoma MIGS evaluation with OD.

Risks and Benefits of Glaucoma Surgery

Benefits

  1. Can slow or halt further optic nerve damage by achieving lower, more stable IOP.
  2. Can reduce dependence on medications and their side effects.
  3. In some cases, more sustainable long-term IOP control than lasers or drops alone.

Risks & Potential Complications

As with any surgery, there are risks. Some include:

  1. Hypotony (too low eye pressure), which can damage structures of the eye
  2. Scarring or closure of the surgically created drainage pathways, which may reduce effectiveness over time
  3. Bleeding or hemorrhage inside the eye
  4. Infection or endophthalmitis (rare but serious)
  5. Damage to cornea or other eye structures
  6. Vision loss or worsening visual field (though the surgery’s goal is to prevent further loss)
  7. Need for additional surgeries if the initial surgery fails or effects wane over time

Because Arizona’s dry climate may affect ocular surface health and healing, surgeons and patients in the state often take special care with postoperative eye hydration and protection against surface drying.

Special Considerations for Arizona Patients

While the fundamental science of glaucoma surgery is universal, living in Arizona adds a few specific angles to consider:

  1. Dry Climate & Ocular Surface HealthArizona’s arid conditions may worsen dry eye symptoms, which can affect healing and patient comfort after surgery. Surgeons may prescribe frequent lubricating drops or punctal plugs to mitigate surface dryness.
  2. UV Exposure & Outdoor LifestyleMany Arizonans spend significant time outdoors. After surgery, you’ll need to protect the eye from sun, dust, and wind by using wraparound sunglasses, hats, and avoiding direct exposure during early healing phases.
  3. Access to Retina / Glaucoma SpecialistsIn urban areas (Phoenix, Tucson), advanced glaucoma and surgical care are accessible. In rural parts of Arizona, travel to specialty centers may be necessary. Patients should plan for follow-up travel and coordination.
  4. Prevalence of ComorbiditiesArizona has a large aging population, and conditions like diabetes, hypertension, and cardiovascular disease are common. These systemic diseases may affect surgical planning, healing, and risk stratification.
  5. Water & Sterility during RecoveryGiven the importance of avoiding contamination while eyes heal, desert dust and hard water could pose increased risk during cleaning or washing. Following strict instructions for eye care hygiene is vital.
Glaucoma Pre surgery patient

Tips for Finding the Right Surgeon in Arizona

  1. Look for a fellowship-trained glaucoma specialist with experience in both conventional and MIGS techniques.
  2. Ask about their complication rates, expected IOP reduction, and follow-up protocol.
  3. Find out whether the practice provides preoperative counseling and thorough postoperative support.
  4. Confirm that the facility is equipped for sterile surgery, emergency care, and postoperative monitoring.
  5. Get referrals from local ophthalmologists and check patient reviews.
Blurry background for design

Get Help Today

If you are at risk for Glaucoma or symptoms of Glaucoma are making you uncomfortable and interfering with your daily life, call us. Our doctors across Arizona have the expertise and tools to give you the relief you need.

Schedule Online