How can I cure myself from glaucoma

Glaucoma surgery


Important NOTE:
The description of the interventions was compiled with the greatest care. However, it can only be an overview and does not claim to be complete. The websites of the service providers and the personal consultation with the doctor or the surgical explanation in the respective operating facility provide further information.
The persons responsible for the content of this website do not guarantee the completeness and correctness of the information, as constant changes, further developments and concretizations are made as a result of scientific research or adaptation of the guidelines by the medical specialist societies.

Here you will find:

A typical symptom of glaucoma, formerly also known as "glaucoma", is an increase in intraocular pressure due to an imbalance between the production and drainage of aqueous humor. The increased pressure inside the eye damages the sensitive optic nerve and retinal cells. The eyesight of the affected eye gradually deteriorates, which is often noticed much too late. Pain is usually only felt in the very rare acute form of glaucoma (glaucoma attack). Since damage to the optic nerve cannot be reversed, all people aged 40 and over are now advised to have a preventive examination by an ophthalmologist who will measure the eye pressure and assess the optic nerve.
If the intraocular pressure cannot be reduced sufficiently with appropriate eye drops or if you cannot tolerate the medication, an operation may be necessary to maintain your eyesight, which can be performed on an outpatient basis.

What happens during this procedure?

Since glaucoma can have many different causes with different anatomical requirements, there are also several surgical procedures.
In the Laser trabeculoplasty is pointed at the spongy drainage tissue of the aqueous humor with an argon laser. The resulting small scars coarsen the meshwork so that the aqueous humor can flow away better. However, the effect is often only temporary.
In the Filtration operation a new drainage path for the aqueous humor is created under the conjunctiva. For this purpose, an opening is cut through the dermis to the anterior chamber in the area of ​​the trabecular structure. An artificial “seepage cushion” is created under the conjunctiva, which can also absorb aqueous humor.
The Iridectomy (Removal of a piece of the iris) creates a flow between the anterior and posterior chambers of the eye. A high-energy infrared laser can also be used to create an artificial gap in the iris (Iridotomy).
The Trabeculectomy is a microsurgical procedure in which a strip of the dermis is cut out together with the Schlemm's canal (canal for the drainage of aqueous humor).
In the Trabeculotomy 6-8 tiny holes are made in the trabecular structure with the so-called eximer laser, which improve the drainage of the aqueous humor. Another laser method - deep sclerectomy - creates a cavity in the dermis through which the aqueous humor can drain.

When does the doctor advise you to have this procedure?

Surgical glaucoma treatment is always recommended if the intraocular pressure cannot be reduced sufficiently with medication and the optic nerve is thereby at risk.

Which stunning method is usually used?

In the case of laser surgery, the use of a local anesthetic in the form of eye drops is often sufficient. Another method is central anesthesia (reference: central anesthesia). This anesthetic also suppresses the protective reflex of the eye and the eye is completely painless and motionless.
If you are one of those people for whom the idea of ​​manipulating the eye is unbearable, general anesthesia may also be an option. This also applies to nervous people who find it difficult to keep their head still for long periods of time.

You will also be given pain medication before and after the operation.

How long does the procedure take on average?

The duration of the procedure depends on the technique used and the respective anatomical requirements. Laser interventions without opening the eyeball usually have a significantly shorter duration.

Who may not be suitable for this procedure?

Not all glaucoma can be treated with surgery. Only the ophthalmologist can decide after appropriate examinations whether an operation is helpful in your specific case.

How is the risk to be assessed?

The risk of glaucoma surgery depends heavily on the condition of the eye before the operation and the technique used.
Your doctor will explain to you in detail about rare complications such as infections, wound healing disorders, visual field defects or bleeding before the procedure.

The success of the operation also depends on proper follow-up care. You should therefore definitely keep the close-knit check-up appointments. Any damage to the optic nerve and retina that has already occurred cannot be reversed even by surgery. Surgery is only performed to preserve the eyesight that is still there. Failure to improve your eyesight should therefore not be viewed as a failure of the operation.

What do you have to consider before the procedure?

If you regularly take medication for other illnesses, you should inform your doctor beforehand, as some medications such as blood-thinning substances should be discontinued a few days before the procedure.

If the procedure is performed under general anesthesia, you should not eat or drink any more cloudy liquids 6 hours before the anesthesia! No clear liquids should be drunk 2 hours before the anesthesia (exception: preparation tablet (s) with a little water). Smoking should not be made on the day of anesthesia. If you take medication in the morning, please discuss with your anesthetist which medication you can still take before anesthesia.

What happens after the procedure and what should you watch out for?

Even with outpatient surgery, you will remain under observation for some time after the procedure - until you feel fit for the way home. You are not allowed to drive your own car on the day of the procedure and you should not use public transport on your own. Have family or friends pick you up or take a taxi home.
For the time after the procedure, the doctor will prescribe drops and ointments, which you should use exactly as directed. Pain medication may also be prescribed for the first few days after the operation.

When does the next doctor's appointment usually take place?

On the day of the procedure, your doctor will tell you when to come back for the next check-up. In your own interest, you should absolutely keep this appointment. Usually the eye bandage is then also removed.
If you get a fever, bleeding or pain at home, you should contact your doctor immediately. Even if you are unsure and still have questions about the normal course of healing, in practice no one will be angry with you if you call for advice.