Glaucoma Surgery in Sydney

Modern glaucoma treatment options

Glaucoma surgery is used to lower intraocular pressure in patients with progressive glaucoma or inadequate pressure control despite laser treatment or eye drops. Modern glaucoma surgery may include minimally invasive glaucoma surgery (MIGS), iStent implantation, trabeculectomy and combined cataract surgery procedures. At Eye & Laser Surgeons in Sydney, Dr Shanel Sharma and Dr Daya Sharma provide comprehensive glaucoma assessment, laser treatment and surgical glaucoma care using modern diagnostic imaging and evidence-based treatment approaches.

Glaucoma surgery is usually considered when:

• eye pressure remains too high
• glaucoma progresses despite treatment
• optic nerve damage continues
• glaucoma drops or laser treatment are insufficient

The aim of glaucoma surgery is to lower intraocular pressure and reduce the risk of further vision loss, when glaucoma laser treatment and/or glaucoma eye drops have been insufficient.

What is glaucoma surgery?

Glaucoma surgery refers to procedures designed to improve the drainage of fluid from the eye and lower intraocular pressure.

Different surgical procedures work in different ways.

Some:

• improve the eye’s natural drainage system
• create new drainage pathways
• reduce fluid production inside the eye

The most appropriate procedure depends on:

• glaucoma severity
• target eye pressure
• optic nerve damage
• previous treatment response
• cataract status

Why does glaucoma surgery matter?

Glaucoma damages the optic nerve gradually over time.

Reducing intraocular pressure remains the only proven method of slowing glaucoma progression and protecting vision.

Some patients achieve excellent pressure control with:

• eye drops
• glaucoma laser treatment
• or a combination of both

Others require surgical treatment to achieve adequate long-term pressure reduction.

Minimally Invasive Glaucoma Surgery (MIGS)

Minimally invasive glaucoma surgery, often called MIGS, includes newer procedures designed to lower eye pressure with:

• smaller incisions
• faster recovery
• lower complication rates than traditional glaucoma surgery

MIGS procedures are often performed at the time of cataract surgery.

One of the most commonly used MIGS procedures is the iStent – cataract Surgery & iStent.

What is the iStent?

The iStent is a tiny implant placed into the eye’s natural drainage pathway.

It works by bypassing resistance within the trabecular meshwork and improving aqueous fluid outflow.

Potential benefits may include:

• lower eye pressure
• reduced dependence on glaucoma drops
• treatment at the same time as cataract surgery

Trabeculectomy surgery

Trabeculectomy is one of the most established glaucoma operations and is often used when very low eye pressure is required.

The procedure creates a controlled drainage pathway that allows fluid to leave the eye more effectively.

Trabeculectomy may be recommended for:

• advanced glaucoma
• rapidly progressive glaucoma
• cases where other treatments are insufficient

Recovery after trabeculectomy is usually longer than after MIGS procedures as this is a more complex procedure.

Tube shunt surgery

In some patients, tube shunt surgery may be recommended.

These procedures use a small drainage device to divert fluid away from the eye and lower intraocular pressure.

Tube surgery is generally reserved for more complex or advanced glaucoma cases.

Combined cataract and glaucoma surgery

Many patients with glaucoma also develop cataracts.

In some situations, cataract surgery can be combined with:

• iStent implantation
• MIGS procedures
• other glaucoma surgery

Combined surgery may:

• reduce treatment burden
• lower eye pressure
• improve visual clarity from cataract removal

Is glaucoma surgery painful?

Most glaucoma surgery is performed using local anaesthesia with sedation.

Patients usually experience:

• pressure sensation rather than pain
• temporary irritation afterwards
• blurred vision during recovery

Recovery depends on the specific procedure performed.

What testing is needed before glaucoma surgery?

Before surgery, glaucoma assessment commonly includes:

• optic nerve examination
• OCT imaging
• visual field testing
• eye pressure measurement
• corneal thickness assessment
• drainage angle assessment

These investigations help determine:

• glaucoma severity
• target eye pressure
• the most appropriate treatment approach

Can glaucoma surgery cure glaucoma?

No.

Glaucoma surgery lowers eye pressure but does not reverse existing optic nerve damage.

The aim is to:

• slow progression
• preserve remaining vision
• reduce future vision loss risk

Ongoing monitoring remains important after surgery.

When do ophthalmologists use glaucoma laser treatment instead of surgery?

Some patients may benefit from glaucoma laser treatment before considering glaucoma surgery.

Selective Laser Trabeculoplasty (SLT):

• is minimally invasive
• performed in clinic
• usually takes less than 5 minutes
• may reduce dependence on glaucoma drops

SLT is commonly used in:

• open-angle glaucoma
• ocular hypertension
• earlier glaucoma stages

Why choose Eye & Laser Surgeons for glaucoma surgery in Sydney?

Eye & Laser Surgeons provides comprehensive glaucoma care in Sydney with clinics in:

• Bondi Junction
• Miranda

Dr Shanel Sharma and Dr Daya Sharma provide:

• glaucoma assessment
• glaucoma laser treatment
• MIGS procedures
• iStent surgery
• cataract surgery
• advanced anterior segment surgery

Patients are assessed individually with attention to:

• long-term visual outcomes
• treatment burden
• optic nerve preservation
• lifestyle considerations

Frequently Asked Questions

What is the safest glaucoma surgery?

The safest procedure depends on the type and severity of glaucoma. MIGS procedures generally have faster recovery and lower complication rates than traditional surgery, but may not achieve pressure levels low enough for advanced glaucoma.

Is glaucoma surgery better than drops?

Some patients achieve excellent pressure control with glaucoma drops alone, while others require surgery to protect the optic nerve.

Can iStent and other MIGS procedures be combined with cataract surgery?

Yes. Surgeons commonly combine many minimally invasive glaucoma surgery (MIGS) procedures, including iStent implantation, with cataract surgery. Combining the procedures can help lower eye pressure while also improving vision affected by cataracts.

Is SLT considered glaucoma surgery?

SLT is a glaucoma laser treatment rather than incisional surgery. It is minimally invasive and performed in clinic.

How long does recovery take after glaucoma surgery?

Recovery depends on the procedure performed. MIGS recovery is often quicker than recovery after trabeculectomy or tube surgery.

Book a glaucoma consultation in Sydney

If you have glaucoma, elevated eye pressure or progressive optic nerve damage, an assessment can help determine whether laser treatment or glaucoma surgery may be appropriate.

If your prescription continues to change, assessment is important.

Book an eye assessment at Eye and Laser Surgeons
Clinics in Bondi Junction and Miranda

Bondi Junction: (02) 9387 5300
Miranda: (02) 9531 5300
Email: reception@eyeandlaser.com.au