Glaucoma
Glaucoma is an eye disease characterized by a chronic, progressive reduction of the thickness of the optic nerve and retinal nerve fibres, which, if left untreated, can cause irreversible visual field loss or even blindness. Its development is closely related to elevated intraocular pressure.
Early detection and treatment are key to preventing permanent vision loss. Regular eye examinations and adherence to appropriate treatment can help prevent glaucoma from causing irreversible vision loss. Surgical treatment of glaucoma is usually necessary when other methods, such as medication or laser therapy, are not sufficient to prevent progression of the disease or to reduce eye pressure. Surgical interventions are usually aimed at reducing intraocular pressure and protecting the optic nerve.
Glaucoma surgery
Deep sclerectomy:
During the procedure, the surgeon makes a tiny window in the eyeball's wall (so-called sclera) to reach the Schlemm's canal, which is a key part of the drainage of aqueous humor. Inside this canal, a thin leaky layer is formed through which the aqueous humour is allowed to drain, thereby reducing the eye pressure. At the end of the operation, the scleral window and the conjunctiva are fixed with sutures, the latter are self-absorbing and fall out spontaneously after a few days.
Canaloplasty:
Canaloplasty is a relatively new and innovative minimally invasive surgical procedure, which is a type of the so-called non-penetrating glaucoma surgeries. In canaloplasty, the eye surgeon makes a window in the sclera of the eye - similar to deep sclerectomy surgery - and then inserts a catheter into the Schlemm's canal. These channels are responsible for the outflow of the eye's internal fluid, the aqueous humour. Once the canal is opened, a thread is placed in the Schlemm's canal using the catheter to ensure that the canal remains open at all times and thus allows the free flow of the aqueous humour via trabecular space.
However, the effectiveness and safety of the procedure will depend on the individual's medical history and other clinical factors. In each case the doctor will evaluate who is suitable for this surgical procedure. In many cases, the patients can completely discontinue previous pressure reducing eye drops after surgery.
How is glaucoma surgery performed?
- The surgery is performed under general anaesthesia and takes about 45-60 minutes, depending on the surgical technique.
- At the end of the operation, a closed covering bandage is placed on the operated eye, which is removed by the surgeon during a follow-up examination on the first postoperative day. After that, the operated eye remains unbandaged.
- After waking up from the anaesthesia and a short rest, the patient can go home with a companion.
- For 3-4 weeks after the operation, eye drops and eye ointments should be regularly used, the exact application of medication will be explained to the patient at the follow-up examination.