In addition to medical therapy with topical eyedrops and laser therapy, surgical options for the management of glaucoma have recently expanded to include a number of new procedures. In cases of the more severe and complex glaucoma, glaucoma drainage devices and tube implant surgery are the surgical options when other traditional interventions have not worked or likely to fail.
Two of the commonly used drainage devices are the Molteno® Implant and the Baerveldt® Implant. These glaucoma drainage devices are surgically implanted in the eye to control fluid leaving the eye through to its absorption into the tissues around the eye. The drainage devices work by consisting of a tube which allows fluid to exit the eye and a plate, which is placed under the white tissue of the eye, around which the fluid circulates and seeps into the surrounding tissues to be absorbed.
Your doctor would recommend a glaucoma drainage device surgery if:
- Your eye pressure is not being adequately controlled with your current medication
- Your glaucoma is progressing
- You experience problems with glaucoma medications or failure with trabeculectomy.
While glaucoma drainage device surgery is reserved for the more difficult and complex glaucoma which intrinsically carries more risks, the majority of these operations work well. Serious complications are rare but some risks associated with glaucoma drainage device surgery include the pressure in the eye becoming too high or too low, bleeding, infection, and inflammation. Occasionally, adjustments or removal of some stitches may be required post-operatively to further stabilize the eye pressure.
Patients who have undergone glaucoma drainage surgery require long-term follow up with their ophthalmologist to monitor their glaucoma. While the surgery will not improve vision, it will reduce the risk of further damage to the optic nerve and preserve functional vision in the longer term.