Glaucoma surgery is a crucial intervention designed to reduce eye pressure and prevent further vision loss in patients with glaucoma. Here, Dr. Thomas Johnson, an ophthalmologist at the Wilmer Eye Institute, Johns Hopkins Medicine, briefly breaks down various glaucoma procedures and post-surgery expectations to help you navigate your recovery process. Understanding what to expect can ensure better healing and outcomes.*

Types of Glaucoma Surgeries and Their Impacts

Glaucoma surgeries aim to lower intraocular pressure through different methods, each with unique risks and recovery considerations. These methods include:

• Enhancing natural drainage. Some procedures improve the eye’s ability to drain fluid through its existing pathways.
• Creating a new drainage pathway. This approach includes the implantation of a tube shunt to direct fluid out of the eye.
• Reducing fluid production. Some surgeries slow the eye’s production of aqueous humor, lowering pressure.

Minimally-invasive glaucoma surgeries (MIGS) are less invasive, involving small incisions without external implants. They generally have a quicker recovery time and lower complication risks. Trabeculectomy and tube shunt implantation carry higher risks but are often more effective at lowering intraocular pressure. Some laser-based surgeries avoid incisions altogether, reducing post-operative discomfort.

Post-Surgical Expectations and Recovery Timeline

Although glaucoma surgery is effective in controlling eye pressure, it does not restore lost vision. Patients should be prepared for temporary side effects, including:

• Blurry vision in the operated eye, improving over several weeks,
• Eye redness, irritation, swelling, tearing, and a sensation of a foreign body in the eye,
• The need for an eye shield, particularly while sleeping, in some cases, and
• Adjustments in prescribed glaucoma medications after surgery.

Most patients experience minimal pain, but any severe discomfort should be reported to an eye doctor. Recovery varies by procedure, with MIGS patients often seeing improvements within days, whereas more invasive surgeries like trabeculectomy or tube shunt implantation may require a longer healing period. Other factors that can affect recovery are:

• The severity of glaucoma, 
• The use of blood thinners, and
• Individual healing responses.

Monitoring Progress and Activity Restrictions

Regular postoperative visits are essential to ensure proper healing. Patients typically have multiple follow-ups in the first few months, with adjustments made to the surgical site if necessary. Johnson highlights that trabeculectomy stitches can be modified postoperatively using a laser to optimize function, but this is only possible within the first few weeks after surgery.

To prevent complications, it’s best to avoid:

• Physical exertion. Strenuous exercise, heavy lifting (over 10 pounds), and bending at the waist should be restricted.
• Exposure to contaminants. Swimming, hot tubs, and wearing contact lenses or eye makeup can increase the risk of infection.
• Driving. Due to sedation effects, driving is not permitted on the day of surgery. Some patients may resume driving once their patch is removed, depending on their vision and comfort level.

Most patients can return to light work within one to two weeks, while daily activities like reading, watching television, and using electronic devices can often resume within a few days. Each patient’s recovery plan should be closely followed with their doctor’s guidance to ensure optimal healing and prevent complications.

By understanding what to expect and following medical advice, you can navigate your recovery from glaucoma surgery with confidence, maintaining your vision health for the long term.

*Johnson, T. V. III. (n.d.). Glaucoma Surgery Recovery: What You Need to Know. Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/glaucoma-surgery-recovery-what-you-need-to-know 

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