Glaucoma Surgery: What to Expect on the Day of Surgery

Glaucoma surgery is done to help lower your eye pressure, also called intraocular pressure. Glaucoma surgery can help to save your vision and prevent further vision loss. There are several types of glaucoma surgeries.

One of the most common glaucoma surgeries is called a trabeculectomy. A trabeculectomy is also sometimes referred to as filtration surgery. You’ll want to confirm with your doctor what type of glaucoma surgery you’re having. Here is more information on what will happen the day of your glaucoma surgery.

Surgeon preparing for eye surgery.
 FG Trade / Getty Images

Before the Surgery

Before your glaucoma surgery, the medical staff working with the eye surgeon may ask you a few questions and help you feel more comfortable. They will take you to the operating room, where you’ll lay down on a stretcher.

You’ll also have your eye cleaned and your face covered by a drape except for the eye slated for surgery. You’ll have monitoring devices attached to help measure your heart rate, blood pressure, and oxygen level.

You will have the surgical eye numbed with eye drops. This will help you to not feel anything around the eye during surgery.

There will be an anesthesiologist to give you sedative medicines intravenously (by IV), and that will help keep you relaxed during your glaucoma surgery. You’ll have instruments placed around the eye to help hold it open.

During the Surgery

During glaucoma surgery, you will be awake but won’t be able to see what is happening except for some bright lights. You most likely will hear people talking. Many eye surgeons also like to play music during surgery.

Try to stay relaxed, without coughing, scratching your face, or moving your legs. If you feel pain, let the operating room staff members know. It’s possible to receive additional medicine to stop pain.

Most people don’t feel anything around their eye during the operation. In rare cases where a person is very anxious or not able to stay still, general anesthesia is used so that person isn't awake for glaucoma surgery.

There will be an eye surgeon, a nurse, surgical assistants, and anesthesia staff present for your glaucoma surgery. Your surgeon will use a binocular microscope to help see the eye during surgery.

Here is what will happen if you are having a trabeculectomy, which is one of the most common glaucoma procedures:

  • Your surgeon will create an opening in the conjunctiva, which is a membrane that covers the front of the eye and that’s found on the inside of the eyelids. The opening is done in a place where others won’t be able to see it, usually under the upper eyelid.
  • A flap will be cut in the sclera, or the white part of the eye, and your surgeon will create an opening to the interior of the eye under the flap. This area, called a bleb, helps fluid referred to as aqueous humor to leave the eye in a controlled way.
  • You may have a second opening cut around the edge of the iris, which is the colored part of the eye. The second opening helps iris tissue to not block the new area where fluid can leave the eye.
  • Your eye surgeon will use sutures to reattach the edges of the flap to the sclera.
  • The area with the flap and the opening are then sutured closed with dissolvable sutures.
  • The eye surgeon will use eye drops or ointments on the eye. These medicated drops can help prevent scarring or infection.
  • You’ll have a patch or shield placed on your eye to protect it from infection.

The creation of the bleb can lower the eye pressure that contributes to glaucoma. The fluid in the bleb will be absorbed by the tissue around your eye. That can help to lower eye pressure.

Sometimes, a trabeculectomy is performed along with cataract surgery. This is appropriate if you require both a trabeculectomy and need a cataract removed. 

After the Surgery

After surgery, you’ll have time to rest in a room separate from the operating area. Before you leave the surgical facility, your eye surgeon will check the pressure in your eye. You can go home once your eye surgeon says it’s OK to leave.

Before you go, you’ll receive written instructions on what you can and can’t do once you leave. The instructions also will have a phone number to call with any general questions or if there is an emergency. If not already scheduled, then the eye surgeon staff members may use this time to schedule follow-up appointments.

You must have someone who can drive you home. This is because you’ve received sedative medications. Also, the eye that had glaucoma surgery will be patched up, making it hard to see with just one eye. That affects your depth perception. If needed, you can hold the hand of the person who accompanied you to get around.

A Word From Verywell

Glaucoma surgery, such as trabeculectomy and other approaches, can be an important piece of the puzzle to help you lower your eye pressure and preserve your vision. Make sure to follow any instructions given to you on the day of surgery to ensure a successful outcome from your glaucoma surgery.

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Article Sources
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  2. Johns Hopkins Medicine. Operations for glaucoma

  3. Boyd K. Glaucoma treatment. American Academy of Ophthalmology.