Glaucoma Surgery

In some patients with glaucoma, surgery is recommended. Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.


Laser Trabeculoplasty

A surgery called laser trabeculoplasty is often used to treat open-angle glaucoma. There are two types of trabeculoplasty surgery: Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT).

ALT Surgery

During ALT surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork. The laser does not create new drainage holes, but rather stimulates the drain to function more efficiently.  This is one of the first laser glaucoma procedures devised and has mostly been replaced with SLT. 

With SLT, a laser is used at different frequencies, allowing it to work at very low levels. SLT treats the mesh-like drainage canals of your eye in order to open it up and let fluid out, lowering the eye pressure.  SLT may be an alternative for those who have been treated unsuccessfully with traditional laser surgery or with pressure-lowering drops.  SLT has been successful in patients who forget to use their glaucoma eye drops, are unable to instill or tolerate eye drops, or cannot afford additional eye drops.   

Even if laser trabeculoplasty is successful, most patients continue taking glaucoma medications after surgery. For many, this surgery is not a permanent solution. Nearly half who receive this surgery develop increased eye pressure again within five years. Many people who have had a successful laser trabeculoplasty have a repeat treatment.

Laser trabeculoplasty can also be used as a first line of treatment for patients who are unwilling or unable to use glaucoma eye drops.

Laser iridotomy is recommended for treating people with closed-angle glaucoma and those with very narrow drainage angles. A laser creates a small opening about the size of a pinhead through the top part of the iris to improve the flow of aqueous fluid to the drainage angle. This opening is hidden from view by the upper eyelid.

Additional types of glaucoma surgeries may be performed in order to help control eye pressure.