Follow-up treatment after filtering glaucoma surgery

After filtering glaucoma surgery, the newly created outflow path can dry up again. In order to identify and treat this at an early stage, close follow-up checks are necessary in the first weeks after surgery. Scarring can be regulated by using eye drops containing cortisone. If the pressure is too low, too much aqueous humor flows out and scarring is desired; cortisone is reduced in this case. Conversely, more drops must be used if there is increased scarring and therefore an increase in eye pressure.

Bulbus massage

After trabeculectomy, regular massage of the eyeball can ensure that the flow of the chamber fluid remains open. This is usually only necessary in the first few weeks after surgery.

risks

• Drop in pressure and choroidal amotion > usually regulates themselves. Vitreous bleeding that reduces vision > resolves on its own after two to four months

goniopuncture

If, after deep sclerectomy, the filtering membrane between the anterior chamber and filter cushion does not allow enough aqueous humor to pass through, the YAG laser can be used to create a small hole in the trabecular system at the angle of the chamber. The discharge rate can thus be increased again

risks

• Loss of pressure and choroidal irritation > usually regulates themselves. Bleeding into the anterior chamber or vitreous body that reduces vision > resolves on its own after two to four months

Needling

If, after deep sclerectomy, trabeculectomy or after MIGS, the filter/seepage pad sticks together as a result of scarring, the drain can be uncovered again with a fine needle. To prevent renewed scarring, a small deposit of mitomycin C can be injected under the conjunctiva.

risks

• Bleeding under the conjunctiva > usually resolves on its own after 1-3 weeks
• Infection in the area of the filter/seepage pad > can be treated by rinsing and with antibiotics. The infection rarely spreads to the inside of the eye > vitreous body surgery is necessary
• Loss of pressure and choroidal irritation > usually regulates themselves. Bleeding into the anterior chamber or vitreous body that reduces vision > resolves on its own after two to four months