Some glaucoma patients can go for years effectively using eye drops and oral medications. If treating your glaucoma with medication doesn’t work for you, however, your doctor is likely to recommend surgery. While surgery can neither cure glaucoma nor reverse existing damage, it can slow—and even halt—disease progression and preserve what vision you have. The National Eye Institute provides an overview of glaucoma surgery options.*

Types of glaucoma surgery

Like medications, glaucoma surgery helps lower intraocular pressure (IOP) in the eye. There are two kinds of surgical treatments available: laser and incisional.

Laser surgery

Your doctor is likely to recommend laser surgery before suggesting incisional surgery, because laser treatments are simpler, less invasive, and carry less risk. During laser surgery, the surgeon uses a focused, intense beam of light to treat your eye’s drainage system, called the trabecular meshwork. Laser treatments are outpatient procedures that are performed in your doctor’s office, a hospital clinic, or another type of outpatient setting.

Incisional surgery

The three primary types of incisional glaucoma surgery are:

• trabeculectomy (“tra-BEK-yoo-LEK-tuh-mee”), 
• glaucoma implant surgery, and 
• minimally invasive glaucoma surgery (MIGS). 

Trabeculectomy

A trabeculectomy is most often used to treat open-angle glaucoma—the most common type of glaucoma in the U.S. The surgery takes place in a hospital and is performed while you’re awake, though you’ll receive medication to numb the eye and help you relax.

During the procedure, your surgeon creates a small opening in the eye under the lid, which allows excess fluid to drain and, thus, lowers the pressure on the eye and optic nerve. Studies show that trabeculectomy is effective in lowering eye pressure in six to eight out of 10 people.

Patients can generally go home the same day, but you’ll need someone else to drive you home. You won’t be allowed to drive right after surgery.

Glaucoma implant surgery

Glaucoma implant surgery is used to treat congenital, neovascular, and injury-related glaucomas. The operation involves the implantation of a small tube in the white part of your eye. The goal of the procedure is to facilitate fluid drainage of fluid and reduce IOP.  

Much like trabeculectomy, glaucoma implant surgery:

• is performed in a hospital, while you are awake;
• involves medication to both numb your eye and help you relax;
• takes approximately one to two hours; and
• allows you to go home the same day, with someone else driving you home. 

Minimally invasive glaucoma surgery

If your glaucoma is mild, you may be eligible for a relatively new approach, called minimally invasive glaucoma surgery (MIGS). MIGS is considered safer than other glaucoma surgeries and usually allows for a faster recovery. There are approximately 12 different types of MIGS, so discuss your options and eligibility with your doctor. 

After surgery

Following surgery, you’ll need to use special prescription eye drops for several weeks in order to prevent infection and swelling. During the recovery period, you may also need to curb certain activities that involve bending and lifting to avoid putting undue pressure on your eyes.

Side effects of glaucoma surgery

As with any operation, glaucoma surgery comes with potential risks and side effects. 

These may include:

• sore and swollen eye(s),  
• cataracts,
• abnormally low eye pressure,
• issues with your cornea (clear front part of your eye), and/or
• vision loss.

Go over the pros and cons of all your options with your ophthalmologist, so you can make an informed decision that’s best for you. 

To learn more about glaucoma surgery, visit the Glaucoma Research Foundation page on glaucoma surgery.

*National Eye Institute, National Institutes of Health. (2019, June 26). Glaucoma Surgery.

Any sources from outside of Prevent Blindness do not imply an endorsement from Prevent Blindness. The contents of the material used are the responsibility of the authoring organization, Responsum Health.