Patient Information

Glaucoma Surgery Information

When eye drops are not enough or cause significant side effects, laser treatments and surgery become the next step. Modern glaucoma procedures, particularly MIGS, allow us to reduce eye pressure safely, minimizing dependence on drops.

This is an educational guide. The surgical decision depends entirely on your anatomical characteristics and the stage of your glaucoma.

Laser and surgical options

Three ways to improve the eye's drainage

The fluid the eye produces has to leave through its natural drain, located in the angle where the cornea and the iris meet. In glaucoma that drain works poorly and pressure rises. What sets each technique apart is where it acts along that pathway.

Before we start · which view this is

  1. The eye seen from the front, with a line marking where the cross-section is taken

    The eye seen from the frontThe line marks where we cut it open.

  2. The eye opened along that cut: the cornea sits at the top and the optic nerve at the bottom

    The eye from the insideThe cornea at the top, the optic nerve at the bottom.

  3. The front part of the eye magnified, which is what the next diagram shows

    This is the area zoomed inThe drawing below shows only that box.

Cross-section of the anterior segment of the eye with the path of the aqueous humourThe fluid is produced behind the iris, passes through the pupil into the anterior chamber and leaves through the drainage angle, where the cornea and the iris meet. SLT laser and MIGS techniques act on that angle. Filtering surgery creates a new outflow pathway under the conjunctiva.CORNEAIRISLENS01SLTimproves the mesh in the angle02MIGSopens or bypasses the angle03FilteringNew pathway

Swipe sideways to see the whole drawing

  • Natural path of the fluid
  • Outflow pathway created by surgery
  • Filtering bleb under the conjunctiva
The drainage angle appears on both sides of the cross-section: it is the same structure seen from its two ends. Proportions are not to scale.
  1. 01

    SLT laser

    Selective laser trabeculoplasty

    Where it actsOn the drainage mesh the eye already has, so that it filters better.

    A procedure of about five minutes, with no incisions. It often makes it possible to delay or avoid the daily use of drops.

    Setting
    In the clinic
    Recovery
    Immediate
    IOP reduction
    Moderate
  2. 02

    MIGS surgery

    Minimally invasive

    Where it actsIn that same angle: they open the natural pathway or bypass it with a microscopic implant.

    Micro-surgeries usually performed at the same time as cataract surgery, with a much faster visual recovery than classic surgery.

    Setting
    Operating room, often alongside cataract surgery
    Recovery
    Fast
    IOP reduction
    Intermediate
  3. 03

    Filtering surgery

    Non-penetrating deep sclerectomy · trabeculectomy

    Where it actsOutside the natural pathway: it creates a new outflow under the conjunctiva.

    Reserved for more advanced cases. It achieves the lowest pressures, at the cost of a longer recovery with frequent check-ups.

    Setting
    Operating room
    Recovery
    Longer, with close follow-up
    IOP reduction
    Maximum

The aim is always the least invasive procedure able to control your pressure in the long term. None of these techniques restores vision that has already been lost: what they do is protect the vision you still have. The choice depends on your test results and the stage of the disease.

Frequently asked questions

No. The procedure is painless and takes only a few minutes. You might feel a slight glare, but most patients tolerate it very well.

Glaucoma has no cure, but MIGS can significantly lower your pressure and often reduce or eliminate your need for daily drops.

The main goal of glaucoma surgery is to preserve your current vision and prevent further loss, not to improve it. However, if combined with cataract surgery, your vision will likely improve.

Ready to discuss surgical options?

If you have questions about whether you are a candidate for SLT laser or MIGS surgery, schedule an appointment.

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