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 only 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, iStent® trabecular micro-bypass, and cyclophotocoagulation are the mainstays of glaucoma surgery at Cole Eye Institute. In addition, newer procedures being performed are goniotomy and gonioscopy-assisted transluminal trabeculectomy (GATT). This year we added hydrus and xen to the armamentarium.

Volume of All Glaucoma Surgeries

2015 - 2019

GATT = gonioscopy-assisted transluminal trabeculectomy

During 2019, the trend for fewer trabeculectomies continued. Cyclophotocoagulation continued to increase over 2018. New for 2019 is the number of Hydrus stents placed (88) and Xen gel stents (28). 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

2015 – 2019

In 2019, twice as many glaucoma implant procedures (152) were done as trabeculectomies (79), an increasing trend since 2016.

Volume of Conventional vs. MIGS

2015 - 2019

The number of procedures utilizing minimally invasive glaucoma surgery (MIGS) has increased yearly since 2015. In 2019, more than twice as many procedures were done with MIGS (484 of 715 or 68%) as were done with conventional surgery (231 of 715 or 32%).

MIGS Volume

2015 – 2019

CPC = cyclophotocoagulation, GATT = gonioscopy-assisted transluminal trabeculectomy