Tube Implant Glaucoma Surgery
Glaucoma is the name for a group of eye conditions which cause damage to the optic nerve at the back of the eye. If the natural fluid which fills the eye cannot drain away properly, this can result in a build up of pressure within the eye. The high pressure can cause loss of vision and, if very high, pain or discomfort. The high pressure may need to be reduced by surgery. A tube–shunt drainage operation is sometimes offered for difficult to control or complex glaucomas, especially where other sorts of surgery may have failed or are likely to fail.
Tube-shunt surgery (Seton glaucoma surgery) involves placing a flexible plastic tube with an attached silicone drainage pouch in the eye to help drain fluid (aqueous humor) from the eye. This type of surgery is usually done after a trabeculectomy has failed. If a person already has or is likely to form scar tissue in the eye, this type of surgery may be done at the start. Tubeshunt surgery is usually done with the person asleep (general anaesthesia). There are many sorts of drainage implants. Some of the names include Molteno, Baerveldt and Ahmed. Broadly speaking, they work in a similar manner. An anti-scarring drug may be used to improve the success of the operation.
Why do I need this surgery?
There are many reasons as to why your ophthalmologist will recommend this operation:
Despite this surgery being used to treat the more difficult and complex glaucomas which carry more risk of problems, the majority of these operations work well. It is important to understand that surgery is designed to work in a staged fashion and may not be working for several weeks afterward. This is preferable to having the operation work immediately which carries the risk of making the pressure in the eye too low. It is not unusual to have adjustment or removal of some stitches post operatively to adjust the pressure in the eye safely. The aim of the operation is to reduce the risk of further damage to the optic nerve. It will not improve sight, but will hopefully help protect vision in the longer term.
What are the risks?
Some risks involved are:
Before the operation
During the operation
The surgery can take up to ninety minutes and is carried out under general anaesthetic. Please expect to be at the hospital/clinic for up to 4 hours.
What you can expect after your surgery
Post-operative care of your eye
If you experience severe pain, sudden loss of vision or discharge contact your ophthalmologist or the eye hospital or clinic where your surgery was performed.