Glaucoma Surgery: How to Prepare

The goal of glaucoma surgery is to reduce intraocular pressure in your eye. There are many different types of glaucoma surgery, such as a trabeculectomy, trabeculoplasty, iridotomy, and glaucoma implant surgery. Laser-based glaucoma surgeries trabeculoplasty and iridotomy require the least amount of preparation.

Although glaucoma surgeries require less preparation than surgery on other parts of the body, you should still prepare for the surgery and know what to expect. As always, talk to your eye surgeon and the practice team if you have any questions.

Model of the eye.
 Denis_Prof / Getty Images

Location

Glaucoma surgeries don’t require an overnight hospital stay. The procedure can take place in several settings:

  • At the ophthalmologist's office
  • In an operating room at an ambulatory surgical center or outpatient clinic: These are buildings where surgery can be performed but where you don’t need to stay in the hospital afterward.

Laser-based glaucoma surgeries, such as a trabeculoplasty and an iridotomy, take place at the ophthalmologist’s office. With laser-based procedures, the eye surgeon can treat both eyes at the same time versus just one eye.

Glaucoma surgeries that take place at an ambulatory surgery center or outpatient clinic include a trabeculectomy and the insertion of a glaucoma drainage implant.

Here’s what you can usually expect to find in the operating room for glaucoma surgery:

  • An operating table where you’ll lay down during the surgery
  • An operating microscope that the eye surgeon will use to see clearly during the glaucoma procedure
  •  A video screen to give the surgeon and staff a more expansive view of the surgical procedure
  • Monitors to help track your blood pressure, heart rate, and oxygen during surgery
  • Various surgical tools used during the surgery

For a laser-based glaucoma procedure, you can expect to find:

  • A slit lamp so the ophthalmologist can see inside your eye
  • The laser used for treatment

What to Wear

Wear comfortable clothing the day of your glaucoma surgery. It can be helpful to wear a shirt you can easily take on and off without moving it past the eye, such as a button-down shirt. That way, you minimize contact with the eye when putting on or removing your shirt.

For a non-laser glaucoma surgery, you will wear a hospital gown on your upper body during the surgery, which means you’ll remove your shirt but not the clothing on the bottom half of your body.

There are a few items you’ll want to avoid using on the day of surgery:

  • Contact lenses: Use glasses instead.
  • Makeup
  • Jewelry
  • Lotions or moisturizers

Food or Drink

Follow any instructions from your eye surgeon about what you can or can’t eat or drink before glaucoma surgery. Most of the time, your eye surgeon will want you to avoid eating or drinking before your procedure.

However, some will say that it’s OK for you to eat beforehand. The difference usually depends on whether or not you will receive anesthesia during surgery.

Medications

Before your glaucoma surgery, always let your eye surgeon know of any medications or dietary supplements that you use. You may be asked to stop certain medications before surgery. Any recommendations on medications to stop using will be linked to the type of glaucoma procedure you are having.

For instance, many ophthalmologists prefer that you stop using blood thinners a week before your surgery. This is to decrease the chance of bleeding during the glaucoma procedure. Your eye surgeon may ask you to stop vitamin E or aspirin in advance of surgery for similar reasons.

Ask your eye surgeon what medicines you can or can’t use the morning of the surgery. Some may say it’s fine if you use medication for diabetes or high blood pressure. Others may ask you to avoid using them but to bring the medications with you. Your eye surgeon also can advise you on the use of glaucoma drops the morning of the surgery.

To help prepare for glaucoma surgery, you may receive prescriptions for several types of eye drops, including:

  • An antibiotic drop to lower the chance of an infection after surgery
  • An eye drop to help fight inflammation
  • A type of medicine called an antifibrotic that lowers your chance of scarring in the eye after surgery

What to Bring

Make sure to have a responsible adult who can drive you home from the appointment and who can drive you anywhere as needed during the day of the surgery. There are a few other things you want to make sure you have with you the day of the surgery:

  • Your health insurance card
  • Any additional paperwork or forms given to you by the eye surgeon

The ophthalmologist's staff will likely request your health insurance information and paperwork in advance of your surgery, but it's always a good idea to have them with you in case any questions come up.

Pre-Op Lifestyle Changes

For any type of surgery, you should try to stop smoking as early as you can before surgery. Smoking can interfere with your healing after surgery. You should also avoid alcohol for 48 hours before your surgery, as alcohol can raise your risk for surgery complications.

A Word From Verywell

Glaucoma surgery may sound intimidating, but it’s often an effective way to lower your intraocular pressure and lower the chance of losing vision. If you have glaucoma and your intraocular pressure is consistently high, it can affect your vision and even lead to blindness if left untreated.

Glaucoma surgery also may reduce the number of eye medications you need to use. Knowing how to prepare for glaucoma surgery can help lower any anxiety you are feeling. Ask your eye surgeon about any special concerns you have regarding glaucoma surgery or your eye health. 

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Article Sources
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  1. American Academy of Ophthalmology. Glaucoma treatment

  2. American Academy of Ophthalmology. Glaucoma drainage implants

  3. Quigley HA. Glaucoma: What every patient should know. Johns Hopkins Medicine.

  4. Johns Hopkins Medicine. Trabeculectomy.

  5. Cleveland Clinic. 3 reasons why smoking before surgery isn’t an option