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Glaucoma is a group of eye diseases that can cause vision loss and blindness by damaging the nerve in the back of your eye called the optic nerve.

If glaucoma medicines and laser treatment haven’t helped to treat your glaucoma, your doctor may recommend surgery. Surgery can’t cure glaucoma or undo vision loss, but it can help protect your vision and stop it from getting worse. 

There are a few different types of surgery for glaucoma that can help lower the pressure in your eye: 

  • Trabeculectomy (tra-BECK-yoo-LECK-toh-mee) 

  • Glaucoma implant surgery 

  • Minimally invasive glaucoma surgery (MIGS) 

If you need glaucoma surgery in both eyes, your doctor will only do surgery on 1 eye at a time.  

What is trabeculectomy?

This type of surgery is usually used to treat open-angle glaucoma. It’s done in a hospital and usually takes less than an hour.  

The surgeon will create a tiny opening in the top of your eye. The opening will be under your eyelid, where no one will see it. This opening allows extra fluid in your eye to drain away, lowering pressure in your eye. 

Usually, you’ll be awake during this surgery — but you’ll get numbing medicine and medicine to help you relax. You can usually go home the same day, but you’ll need someone to drive you home. 

What is glaucoma implant surgery?

This type of surgery is used to treat several types of glaucoma, including congenital glaucoma, neovascular glaucoma, and glaucoma caused by an injury. It’s done in a hospital and usually takes 1 to 2 hours.   

In this operation, the surgeon implants a tiny tube, or shunt, onto the white part of your eye. The tube helps extra fluid drain out of your eye, lowering your eye pressure.  

Usually, you’ll be awake during this surgery — but you’ll get numbing medicine and medicine to help you relax. You can usually go home the same day, but you’ll need someone to drive you home.

What is minimally invasive glaucoma surgery (MIGS)?

If you have mild glaucoma, your doctor may recommend a new approach called minimally invasive glaucoma surgery (MIGS). This also lowers eye pressure, but it has fewer risks and side effects and helps you recover faster.  

There are different types of MIGS, so ask your eye doctor about whether MIGS may be an option for you.

What happens after surgery?

Your doctor will prescribe eye drops to help prevent swelling and infections, and you’ll need to use them for several weeks. These eye drops are different from other glaucoma eye drops you may already use. 

While you recover, you may need to avoid some activities for 2 to 4 weeks, like lifting anything heavy. You’ll also need check-ups with your doctor to make sure your eye is healing well.  

Will I need surgery again?

For some people, the benefits of surgery last a long time. For others, the opening in the eye begins to close up and they need surgery again. You’ll need regular check-ups with your doctor to test your eye pressure. That way, your doctor will be able to act fast if you need more treatment.  

Research shows that trabeculectomy can lower eye pressure in about 7 out of 10 people. It may work best in people who haven’t had an eye injury or another eye surgery.

What are the side effects of surgery for glaucoma?

Glaucoma surgery can have side effects, just like any operation. For example, your eye may be swollen and sore for a while.  

Other possible risks of glaucoma surgery include:  

  • Cataract  

  • Problems with the cornea (the clear front layer of your eye) 

  • Eye pressure that’s too low 

  • Vision loss  

Talk over the pros and cons of surgery with your doctor. Together, you can make a treatment plan that’s right for you. 

Last updated: January 3, 2022