Procedural and surgical treatment of glaucoma. All the nuances

You are about to undergo surgery for glaucoma.

Our clinic performs combined surgical eye treatment, which consists of 2 stages - surgical and laser.
First, the surgeon will perform a gentle, non-penetrating operation. And the second stage will be laser goniopuncture. An important advantage of this approach to the treatment of glaucoma is the restoration of the outflow of intraocular fluid through natural channels. Modern equipment from Germany and the USA, disposable consumables provide excellent results, reduce the risk of complications, and shorten the postoperative period. All medical equipment and consumables are certified by the Ministry of Health of the Russian Federation and approved for use in medical institutions in Russia. The operation is performed by highly qualified surgeons.

Laser treatment

This intervention is performed using a laser on the membranes and directly inside the eye. In this case, the eye cavity is not opened, so there is no risk of complications. In this case, the laser beam is a kind of knife. Laser surgery allows the intervention to be performed on an outpatient basis. The patient does not require long-term recovery.

Depending on the lasers used, the application may vary:

1) the appearance of a tissue micro-explosion - when using destructive lasers; 2) causing a local burn with subsequent tissue scarring - when using laser coagulators.

The essence of laser treatment is as follows:

— an incision of up to 1.5 mm is made; — a very thin glass fiber is inserted into it, through which a laser beam is passed; — the laser operates for 5 seconds.

Of the many types of laser surgeries, the most popular are trabeculoplasty and iridectomy.

Laser trabeculoplasty

This surgical intervention is minimally invasive. Used for primary open-angle glaucoma. The laser beam is exposed to the trabecular zone in the projection of Schlemm's canal. The laser beam creates small holes in the trabecular meshwork, which is responsible for the outflow of fluid.

This treatment method makes it possible to reduce the pressure inside the eyeball, as well as the risk of complications.

Laser treatment for glaucoma lasts approximately 40 minutes and has no age restrictions. Local anesthesia is used. The procedure does not require general anesthesia.

Trabeculoplasty also allows you to:

• normalize microcirculation of intraocular fluid;
• improve metabolic processes occurring in the optic nerve;
• eliminate the consequences of nerve hypoxia.

When glaucoma occurs, surgery removes part of the trabecula. This allows the conjunctiva and chamber to communicate directly with each other.

The disadvantage of this treatment method is that it is not always effective.

Laser iridectomy

Laser iridectomy has proven itself quite well. It allows communication between the anterior and posterior walls of the fundus. What helps reduce IOP levels. Iridectomy is indicated for patients with a sharp decrease in visual function. Contraindications include clouding of the cornea. swelling or other problems.

Only local anesthesia is required. A miniature hole is made in the pupil. Long-term rehabilitation is not required. After iridectomy, the natural circulation of the ocular fluid is restored.

The disadvantages of iridectomy include the possibility of damage to the vessels of the iris or lens capsule, as well as the possibility of closing the resulting hole, which will require repeated intervention.

Preparing for surgery

• Before the operation, you need to undergo a general examination according to the given list of tests and a glaucoma diagnosis. When the examinations are completed, call the clinic at 8 (391) 2-911-494 and make an appointment with a surgeon and anesthesiologist for a preoperative examination.
• Preoperative examination is carried out the day before the day of surgery. You must bring your test results with you. During the preoperative examination, the tactics and type of surgical intervention will be chosen for you. Preoperative preparation (eye drops, tablets) will also be prescribed. You will also be asked to sign “informed voluntary consent” for the operation (in accordance with Article 20 of the Russian Law on the Protection of Citizens’ Health).
• Attention! 5 days before the preoperative examination, you must stop instilling Travatan or Xalatan drops (if they were previously prescribed to you). On the day of the operation, you need to take the medications that will be recommended to you by the anesthesiologist. Before surgery, do not eat for 4 hours.
• You must appear at the clinic on the day of the operation at the appointed time (usually 30 minutes before the start of the operation). Woolen items should not be worn in the operating room, so please bring a comfortable change of clothes with you.

Postoperative recommendations for the patient

Glaucoma is a disease that can develop unnoticed by a person. You need to pay attention to the symptoms of the disease and not ignore them, consult a doctor in a timely manner. If frequent disturbances in intraocular pressure are observed, then this is an important and dangerous signal. In such cases, the use of eye drops is often prescribed. But if they do not help, then the causes of the disease are deeper.

Experts recommend that patients, first of all, resort to laser treatment and only then to conventional surgical intervention.

Performing laser trabeculoplasty

Thanks to the first method, it is possible to minimize all negative consequences, as well as complications. The main purpose of the operation is to normalize intraocular pressure, as well as improve the outflow of fluid from the eyes. Before resorting to surgery, the patient, of course, will receive qualified advice from a specialist and weigh the pros and cons. If the patient has concomitant diseases, such as cataracts, for example, then he may be offered hospitalization in particularly severe cases. Thanks to this, the patient will be in optimal conditions for healing. He is guaranteed constant supervision, and all necessary tissue treatments will be carried out in a timely manner.

Consultation with an ophthalmologist before surgical treatment

Glaucoma is a disease that is chronic. With the help of various modern means, the development of the disease can be significantly slowed down. But it is extremely difficult to get rid of it completely. The patient must take this into account. Relapses of glaucoma may occur after surgery. Such cases are not that rare.

Glaucoma may recur

The patient will need to follow the doctor’s recommendations for a long time and use the medications that were recommended. It is very important that treatment for this disease is started in a timely manner. Then it will be possible to significantly slow down the development of the disease. The person will regain normal vision and it will remain that way for many years. Do not forget about periodic visits to the doctor’s office after all procedures performed to eliminate glaucoma. To prevent recurrence of the disease, the patient is recommended to:

• wear anti-glaucoma glasses in hot weather;

If the patient underwent surgery to eliminate glaucoma using the usual method, then after all the operations, increased tearing of the eye may be observed, irritation and redness are also characteristic. During the intervention, the surgeon makes holes so that the eye fluid flows out calmly. For some time after the operation - 6-7 weeks, the patient's vision may be blurred, but then it improves and returns to the condition that was present before the intervention. Experts prescribe the use of the drug pilocarpine. Thanks to it, the pupil size is normalized. The patient may need to replace lenses or glasses after surgery. You also need to ensure that no infection gets into the bladder in which eye fluid accumulates after the intervention.

Video - Glaucoma

Video - Treatment of glaucoma

Video – Laser eye surgery

The term glaucoma refers to a disease of the visual organs. Their characteristic feature is a regular or constant increase in intraocular pressure (IOP). There is a decrease in visual acuity, the development of visual field defects, and even complete dysfunction of the optic nerve. Depending on the severity, glaucoma can be treated with medications or surgery, which involves surgery or laser treatment of glaucoma.

Operation

1. The surgery is performed on an outpatient basis, under local anesthesia. It takes 15-20 minutes. After the operation, you will be under the supervision of an anesthesiologist in the recovery room for 1 hour, then you will be allowed to go home. After surgery, a bandage is applied to the eye - a sticker that does not need to be removed until the next morning.
2. The laser stage of the operation is also performed on an outpatient basis, under local anesthesia (drops). After it, you can immediately go home, and out-of-town patients will be able to go home and be seen by an ophthalmologist at their place of residence.

Recovery after eye glaucoma surgery: rehabilitation and vision support

This is what healthy eyes look like

When drug treatment for glaucoma does not provide effective results, surgery should be performed.

In medicine, several types of operations are used for this disease. Surgery is performed to reduce eye pressure and improve the drainage of eye fluid. It also relieves pressure on the nerve and improves its blood supply. And if after half a year the eye pressure returns to normal, this means that the operation was successful.

Types of operations

• Fistulizing operations. They are also called penetrating. The most common of these is trabeculectomy. During this operation, a puncture is made in the eyeball and a permanent drainage is installed.
• Non-fistulizing operations, one of which is sclerectomy. These are non-penetrating operations, the purpose of which is to drain fluid through natural pores.
• Operations that restore fluid circulation. Such operations include iridectomy and iridocycloretraction.
• Surgeries that completely reduce the accumulation of fluid in the eyeball. These include cyclocryocoagulation and laser cyclocoagulation.

To prevent glaucoma from returning after surgery, you should know what to expect during this period. This will be discussed below.

Important: If the operation has not been performed, the patient with glaucoma has restrictions in certain actions. They are described in more detail here.

Who can have glaucoma surgery?

The operation is prescribed for those who have been diagnosed with the first two stages of angle-closure glaucoma. And also with mixed disease.

The operation is performed under local anesthesia by instilling drops such as iceocaine, xylocaine or inocaine into the eye.

In this case, a special lens is placed on the eye, thanks to which the laser is directed precisely to the desired area of ​​the iris.

Sometimes it happens that the hole does not come out or closes. In this case, the operation is repeated.

The goals of surgery are:

1. Reduced internal eye pressure.
2. Improved circulation in the optic nerve.
3. Improving nutrition of eye tissue.

And if the pressure remains normal for a certain time, then such an operation is considered successful.

If glaucoma nevertheless progresses, complications will occur within the first six months of the postoperative period.

What complications can there be after surgery?

But despite the popularity of the operation among ophthalmologists, this procedure for illness has a number of disadvantages:

• In some cases, new outflow channels are blocked by scars. And, unfortunately, repeated surgery does not bring the desired result.
• The scar can grow on the cornea of ​​the eye and cause an inflammatory process. Because of this, the eye will stop seeing.
• Sometimes it may happen that the fluid flows out faster than it accumulates. This can lead to a decrease in internal eye pressure. This will be very bad for the eye.
• Clouding of the lens may occur or a film may form, that is, cataracts may develop.

Postoperative period

It is very important to know what can and cannot be done after glaucoma surgery, since it is in the first ten days that the operated person requires special care, which consists of the following parts:

Postoperative care . It is strictly forbidden to wash the operated eye. Do not scratch or rub, or press on the eyeball. And it is also forbidden to self-medicate in the postoperative period and instill eye drops that you have made or “prescribed” yourself.

Under no circumstances should you wash your operated eye.

Dream . Sleeping is allowed only on the side, but only in such a position that the sore eye is at the top. You should not sleep on your stomach or on the side of the affected eye, as circulation in the eye may be impaired. Hephema may also occur, which usually occurs when the eye is injured or pressure is applied to the eyeball.

Nutrition. During the postoperative period, you should avoid solid hot foods, as well as salty or pickled foods. The rest of the diet can remain the same.

Daily activity . After surgery, you should avoid physical activity. In addition, you should not take a steam bath or sauna.

Visit doctor . After the operation, you should follow all the doctor’s recommendations and come to your appointment on time. Because such actions will prevent all sorts of complications.

Vision restoration

Many people wonder whether it is possible to restore vision after glaucoma surgery? This question is addressed to specialists.

Important: But alas, vision cannot be restored. Because during the disease the optic nerve atrophies and, as a result, vision decreases. Treatment of the disease consists only of reducing the internal eye pressure using drops or surgery.

The doctor's comments on this matter are in the video below:

Rehabilitation after surgery

Treatment of glaucoma after surgery consists mainly of preventing the disease and maintaining normal eye pressure.

At first, you need to take eye drops prescribed by your doctor. This can be done by the patient or close relatives. This procedure should be carried out with thoroughly washed hands.

The drops prescribed by the doctor are Tobradex, Indocolir, Korneregel.

Important: It should be remembered that drops cannot be used without a doctor’s prescription.

Second eye support

With this disease, many people ask how they can save the second eye after surgery. But it should be remembered that each medicine will act effectively only at the initial stage of the disease.

To maintain eye pressure, you should prepare the following drug:

Grind the aloe leaf into a fine pulp, add a teaspoon of crushed rosehip roots and flowers, as well as dry walnut leaves.

Aloe leaves need to be crushed to this state

This medicine should be taken before meals, one tablespoon at a time. The course of treatment lasts two decades, then a three-day break is taken, then the course of treatment must be continued again.

How to maintain normal vision

When asked how quickly vision returns after glaucoma surgery, doctors cannot give a definite answer. But they recommend making lotions from sheepshead tincture.

You can make a medicinal tincture from sheepsfoot

Preparation: pour a tablespoon of herbs into two glasses of water and leave. Then use this infusion both internally and externally.

A sick person should take half a glass of tincture three times a day. At the same time, lotions are applied to the eyes. To do this, take a cotton cloth, soak it in the tincture and apply it to the eyes for five minutes.

The use of this infusion has a very beneficial effect on vision.

Can I wear glasses?

Some people had vision problems before surgery and were forced to wear glasses, and in the postoperative period it is recommended not to overstrain their eyes. So people are wondering whether it is possible to wear glasses after glaucoma surgery.

Important: Doctors recommend starting to use them one and a half months after the operation. And after three months you should undergo an examination with your attending physician or at your place of residence.

In addition, doctors recommend wearing tinted glasses outside so that bright light does not irritate the sore eye.

Follow your doctor's recommendations and stay healthy!

SEE ALSO: Flat glaucoma Wine glaucoma Where can glaucoma be operated on

Postoperative regimen

• After the operation, you will be given drops and instructions on how to instill them into the operated eye.
• An eye patch must be worn for the first 3 days after surgery. On the street, it is better to cover the operated eye with a bandage for 7-10 days.
• If you are irritated by light in the first days after surgery, you can use sunglasses. When washing the operated eye, do not wet the operated eye for 10 days; you can wash your hair 7 days after the operation.
• You can watch TV, read, and do light housework 5 days after surgery.
• You can eat as usual, but you should avoid foods that cause indigestion and constipation, as well as too salty foods (especially in the first days).
• For 10 days after surgery, it is prohibited to: sleep on the side of the operated eye; drink alcoholic beverages; work in an inclined position; lift more than 5 kg.

The first examination by the surgeon is carried out the day after the operation. Further examinations and prescriptions are determined by the surgeon depending on the condition of your eye. For working patients, from the day of surgery, a certificate of incapacity for work is issued for the entire rehabilitation period (10-14 days).

All examinations and examinations in the clinic before and after surgery are carried out by appointment!

Work and rest schedule

Patients with glaucoma are contraindicated: heavy physical labor, activities with the head tilted, heavy lifting, work in a hot shop, overwork, strenuous sports.

It is especially worth considering for summer residents, among whom there are many elderly people. If you are suspected of glaucoma or this diagnosis has already been established, you need to make it a rule not to work in the beds while bending down. Of course, you can take care of flowers, pick berries from the bush and do homemade preparations. All other work on the ground, alas, is contraindicated. With glaucoma, the cottage should only become a place of rest.

In the summer, people with glaucoma must protect their heads from the sun. Swimming in cold water is contraindicated for them, as this can lead to vasospasm. Avoid wearing tight collars, tight ties, belts and belts, which can impede blood circulation.

With glaucoma, it is also undesirable to stay in the dark for a long time, due to the dilation of the pupil, which leads to an increase in eye pressure. To preserve your eyesight, it is recommended to watch TV in sufficiently bright lighting.

Before going to bed with glaucoma, be sure to ventilate the room, it is better to raise the pillow under your head. After waking up, you should immediately get out of bed, since the highest intraocular pressure usually occurs in the morning. To preserve your vision, you should get at least 8 hours of sleep. Driving with glaucoma, even with fairly high visual acuity, is quite dangerous, since it may suddenly worsen if an acute attack of glaucoma occurs.