Selective Laser Trabeculoplasty

From £800 per eye

What is Selective Laser Trabeculoplasty?

There are different ways in which laser therapy can be used to treat patients with glaucoma. Selective laser trabeculoplasty is a treatment for patients who have open angle glaucoma.

If you have healthy eyes, the fluid in your eye (aqueous humour) flows through your pupil into the front of your eye. It then drains away through drainage channels inside the eye called the trabecular meshwork. These drainage channels are situated in the angle of the eye, which is where cornea (clear front layer of the eye) and iris (coloured part of the eye) meet.

However, in some eyes these drainage channels do not work properly, so your eye pressure increases. This increase in pressure may injure your optic nerve (the nerve that carries information from your eye to your brain) and impair your vision. This is called glaucoma.

In this trabeculoplasty procedure, a laser beam is applied to the drainage channels to unclog them. This means the aqueous humour flows through the channels better, reducing the pressure in your eye.

Trabeculectomy

From £6000 per eye

What is a trabeculectomy?

A trabeculectomy (trab-ec-u-lec-tomy) operation may be recommended if your glaucoma continues to progress despite using eye drops and/or having had laser treatment. The goal of trabeculectomy surgery is to help lower and control your eye pressure.

The trabeculectomy is an operation to create an alternative drainage channel in the white of your eye (sclera) to allow aqueous fluid (natural fluid) to drain from your eye into a reservoir called a bleb underneath the top eyelid, and then to be absorbed by the body. This new pathway bypasses the blocked natural drain (trabecular meshwork) of your eye.

We understand how precious your vision is… Ms Pearsall will guide you through your personalised treatment plan.

Remember we are with you every step of the way.

Shunt Surgery

From £7000 per eye

Glaucoma is usually treated successfully with medication to lower the pressure in the eye. If medication is not effective, laser and other surgical procedures may be of value in controlling the pressure and preventing further vision loss. Glaucoma tube surgery may be recommended if the pressure in your eye is uncontrolled. If left untreated it is very likely you will gradually lose vision in that eye.

What are aqueous shunts and what do they do?

Aqueous shunts are microsurgical drainage devices that help control the intraocular eye pressure (IOP) in glaucoma by creating a new drainage channel for the eye which results in a small blister or bleb behind the eyelid. Reducing the pressure on the optic nerve in this manner prevents further damage and further loss of vision in glaucoma.

Please note that control of the eye pressure with an aqueous shunt will not restore vision already lost from glaucoma.

There are many implants that can be used but the most common ones are Baerveldt implant, the Molten implant and the Ahmed glaucoma valve. They all consist of a small tube that takes the fluid from inside the eye (aqueous humour) to a plate underneath the outer coat of the eye (conjunctiva). The tube and bleb are mostly hidden under the eyelid.

Although all shunts perform approximately the same function, there are important differences that affect the eye pressure in the first few weeks after surgery and other differences that influence the healing of the eye around the shunt and the long-term eye pressure.

The Ahmed Glaucoma Valve contains a type of valve that helps to prevent very low eye pressure during the first few weeks after surgery. The Baerveldt and Molteno implants do not contain valves but do have other advantages. Because the Baerveldt and Molteno implants have no valve, they must be blocked with a stitch that is either tied around the outside of the silicone tube (external ligature), or threaded through the inside of the tube (occluding suture) at the time of surgery. The purpose of the stitches is to prevent the shunt from draining excessively in the first few weeks after surgery and causing the eye pressure to be too low.