Glaucoma: Forms & treatment options (Surgery & Laser) in Turkey

Understanding How Glaucoma Treatment Works

Glaucoma treatment typically works by lowering intraocular pressure, as optic nerve damage usually occurs because the pressure within the eye gets too high.Glaucoma treatments focus on improving aqueous flow to lower intraocular pressure. Since glaucoma cannot reverse vision loss, early intervention is essential to prevent further deterioration.

Medical Management with Eye Drops

Treatment usually begins with prescription eye drops that must be taken daily.Since the introduction of latanoprost more than 30 years ago, prostaglandin analogs have become a widely used first-line treatment for glaucoma, with agents such as latanoprost, travoprost, bimatoprost, and tafluprost all demonstrating effective intraocular pressure reduction with minimal adverse effects.In clinical trials, latanoprost, travoprost, and tafluprost have demonstrated an intraocular pressure-lowering ability of 25% to 32%, while bimatoprost has been shown to lower intraocular pressure by 27% to 33%.Frequently, more than one drug is needed to control intraocular pressure, with beta blockers, topical carbonic anhydrase inhibitors, and alpha-adrenergic agonists commonly used in addition to prostaglandin analogs.

Laser Treatment

Laser procedures are used when other treatments, like eye drops, are not enough to control high pressure.Laser trabeculoplasty can be done at a clinic or hospital, where the doctor puts numbing drops in the eye, uses a special microscope with a lens placed on the eye, and guides the laser beam to the trabecular meshwork to apply small amounts of energy.It can take from about 6 to 8 weeks for laser trabeculoplasty to fully lower eye pressure.Patients may need the doctor to check within an hour of surgery and will also need to see the doctor for a follow-up exam, usually within 4 to 8 weeks after treatment.

Surgical Options

Glaucoma surgery helps lower pressure inside the eye to prevent further damage to the optic nerve and protect vision when other treatments like eye drops or laser procedures are not enough to control high pressure.Minimally Invasive Glaucoma Surgery procedures include microsurgical instruments and devices with smaller incisions that manipulate eye tissues less and therefore reduce the risk of complications.Minimally Invasive Glaucoma Surgery is considered to have shorter surgical time and fewer severe complications when compared to traditional glaucoma surgeries such as trabeculectomy.Minimally Invasive Glaucoma Surgery options work either by bypassing the trabecular meshwork, increasing aqueous outflow through Schlemm's canal, increasing uveoscleral outflow, aqueous shunt through subconjunctival space or by ciliary body ablation.Trabeculectomy, still considered the gold standard in glaucoma surgery, involves creating a new pathway for the eye to drain fluid, with a surgeon creating a flap in the sclera underneath the upper eyelid to allow fluid to drain, bounded by the outermost covering of the eye.Most procedures are done in an outpatient setting so patients can go home the same day, though immediately after surgery, the eye may feel sore or be red, or vision may be blurry for a few days.Once patients are taking medications for glaucoma, ophthalmologists will want to see them regularly, with visits expected about every 3 to 6 months.