Glaucoma Surgery

About Glaucoma Surgery

Glaucoma is the second most common cause of irreversible blindness in the United States, after age-related macular degeneration. While visual loss from glaucoma cannot be reversed, adequate control of intraocular pressure (IOP) can halt or slow the progressive loss of vision.

Medications such as eye drops can help patients avoid the need for laser treatment or surgery, but these entail long-term cost and some potential for local and systemic side effects. Laser treatment for glaucoma is generally quick, safe, and convenient, but in many patients it has a relatively small effect in reducing IOP, and the effect may wear off over time. For some patients, surgery to control IOP and prevent glaucoma progression is the best option.

Glaucoma implants, trabeculectomies, and cyclophotocoagulation are the mainstays of glaucoma surgery. In addition, minimally invasive glaucoma surgeries (MIGS) are being performed such as iStent® trabecular micro-bypass goniotomy, gonioscopy-assisted transluminal trabeculectomy (GATT), hydrus and xen.

Volume of All Glaucoma Surgeries at Main Campus

2018 - 2022

GATT = gonioscopy-assisted transluminal trabeculectomy

In 2022, the number of glaucoma surgeries performed at main campus was N = 1001. During this time, the trend for fewer trabeculectomies continued. Revisions of glaucoma implants and trabeculectomies decreased considerably in 2021 and 2022, and no iStents were placed in 2022. The institute did fewer procedures overall in 2020 and 2021 due to the COVID pandemic, but the volume increased substantially in 2022. Results will be tracked going forward to assess trends in newer procedures or minimally invasive glaucoma surgery (MIGS).

Volume of Trabeculectomy and Glaucoma Implant Surgeries

2018 – 2022

In 2022, the overall number of procedures increased to more than prepandemic levels (277), and there were more than four times as many glaucoma implant procedures (229) done as trabeculectomies (48), an increasing trend since 2018.

Volume of Conventional Surgery vs. MIGS

2018 - 2022

Trab = trabeculectomy; GI = glaucoma implant; MIGS = minimally invasive glaucoma surgeries

The number of procedures utilizing minimally invasive glaucoma surgery (MIGS) has increased yearly since 2018. In 2022, this trend continued. Only 28% (277) of 989 procedures were done with conventional surgery, as opposed to 72% (712) done with MIGS.

MIGS Volume

2018 – 2022

CPC = cyclophotocoagulation, GATT = gonioscopy-assisted transluminal trabeculectomy