Advanced Surgical Procedures for Glaucoma
When medications and less invasive procedures aren't sufficient, advanced surgical options create new drainage pathways to protect your vision.
When is Advanced Surgery Needed?
Advanced glaucoma surgery is considered when eye pressure cannot be adequately controlled with medications, laser treatments, or MIGS procedures.
Maximum Protection
Creates powerful new drainage pathways to achieve significant and sustained pressure reduction.
Advanced Cases
Particularly effective for advanced glaucoma where aggressive pressure control is essential.
Long-Term Solution
Provides lasting pressure reduction, often for many years, with proper follow-up care.
Benefits of Advanced Glaucoma Surgery
- Significant and sustained reduction in eye pressure, often achieving levels not possible with medications or less invasive procedures alone
- Long-term preservation of vision by halting or slowing the progression of glaucoma damage
- Effective treatment option even in advanced or complex cases of glaucoma where other treatments have not been sufficient
- Improved quality of life by reducing the burden of daily medication schedules and frequent medication-related side effects
Advanced Procedures We Offer
At West Metro Eye, our experienced surgeons perform advanced glaucoma procedures with precision and care. The following is a general overview of the different advanced surgical procedures we offer; your surgeon will discuss the specifics and recommend the best option for you during your visit.
Xen Gel Stent
The Xen Gel Stent is a soft, flexible microtube that creates a new drainage pathway from inside the eye to a space under the conjunctiva (outer eye tissue).
How It Works:
- • Soft gelatin stent (6mm long, about the thickness of a human hair)
- • Implanted through a tiny incision from inside the eye
- • Directs fluid to new drainage area (bleb) under conjunctiva
- • Designed to expand after placement for optimal flow
Tube Shunts (Glaucoma Drainage Devices)
Tube shunts (also called aqueous shunts or glaucoma drainage implants) are small devices that permanently redirect eye fluid to a reservoir plate, lowering pressure reliably.
How It Works:
- • Silicone tube inserted into the front chamber of the eye
- • Connected to a plate secured to (via sutures) the sclera (white part of the eye)
- • Drains fluid from eye to reservoir under conjunctiva
- • Permanent implant that continuously drains fluid
Trabeculectomy
Trabeculectomy creates a new drainage channel, allowing fluid to bypass the clogged trabecular meshwork.
How It Works:
- • Creates a tiny flap in the sclera (white of eye)
- • Removes a small piece of trabecular meshwork
- • Forms a filtering bleb (fluid reservoir) under conjunctiva
- • Fluid drains through bleb and is absorbed by surrounding tissue
- • Special medications called anti-metabolites (MMC or 5-FU) are used to prevent scarring
Recovery & Follow-Up Care
What to Expect
- • Recovery takes several weeks to months
- • Vision may be blurry initially as eye heals
- • Multiple prescription eye drops required
- • Frequent follow-up visits in first few months
- • Gradual return to normal activities
- • Final pressure stabilization may take 6-12 weeks
Activity Restrictions
- • Avoid strenuous activities for 3-4 weeks
- • No heavy lifting (over 10-15 pounds)
- • Protect eye from injury or trauma
- • No swimming or hot tubs until cleared
- • Avoid rubbing or pressing on the eye
- • Sleep with protective eye shield initially
Contact Your Doctor Immediately If You Experience:
- • Sudden vision loss or significant vision decrease
- • Severe eye pain not relieved by prescribed medication
- • Signs of infection (increasing redness, discharge, swelling)
- • New floaters or flashing lights
- • Persistent nausea or vomiting