There is no surgery that is specifically indicated for open-angle glaucoma. However, some types of glaucoma surgery are more likely to work in open-angle glaucoma compared to closed-angle glaucoma. Below is a short summary.
All glaucoma surgery attempts to slow or stop further loss of vision by reducing intra-ocular pressure. With the exception of treatments that reduce fluid production in the eye (often reserved for end-stage or complex glaucoma), this is achieved by increasing the rate at which fluid leaves the eye. The commonest procedure is called “Trabeculectomy” and involves the creation of a channel between the inside of the eye (anterior chamber) and the space under the surface membrane of the eye (conjunctiva). When working, fluid flows into the space under the conjunctiva that in turn is absorbed via blood vessels back into the body. Another common procedure is a glaucoma drainage device. This is where a tube, typically silicone, is inserted in a way that again connects the inside of the eye with space beneath the conjunctiva. Both Trabeculectomy and glaucoma drainage devices may be used in open-angle or closed-angle glaucoma.
In contrast, another group of operations will not work if there is a closed angle. These are collectively termed “non-penetrating glaucoma surgeries”. They work by helping fluid flow more efficiently through the natural outflow mechanisms of the eye. In order for this surgery to work, it is a requirement that the angle between the cornea and iris remain open. So in this instance, this type of surgery may be indicated in open-angle glaucoma but not closed-angle glaucoma.
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