How Long Does Glaucoma Surgery Take?

Wondering how long glaucoma surgery takes to complete? Well you are in the right place. Glaucoma surgery comes in many different forms and how long the surgery takes depends on three major factors. 

The first is the type of surgery that is being done. MIGS procedures are shorter and less complicated while a trabeculectomy or a tube will take longer. The other factor affecting surgical time is the health of the eye. In eyes that are unhealthy, have severe diabetes or have had multiple other surgeries, glaucoma surgery can take longer.  Finally, the surgeon’s experience and skill lever also contribute to surgical time. 

Let’s take a look at the different surgical times for glaucoma surgeries. 

How Long Does Glaucoma Surgery Take For MIGS Procedures?

MIGS stands for “Minimally Invasive Glaucoma Surgery.” It refers to a group of surgical procedures that are designed to reduce intraocular pressure (IOP) in patients with glaucoma using minimally invasive techniques. These procedures are typically performed in conjunction with cataract surgery, although they can also be performed as standalone procedures.

Why Are MIGS So Popular?

MIGS procedures are characterized by their minimal tissue disruption, small incisions, and relatively quick recovery time compared to traditional glaucoma surgeries. They aim to improve the outflow of aqueous humor from the eye to reduce IOP and slow down the progression of glaucoma. 

Types Of Glaucoma MIGS Surgeries

Kahook Dual Blade: The Kahook Dual Blade (KDB) is a surgical instrument used in glaucoma surgery. It is designed to perform a minimally invasive procedure called goniotomy, which involves creating an opening in the trabecular meshwork of the eye to improve aqueous humor outflow and reduce intraocular pressure.

iStent: Similar to the trabecular micro-bypass stent, the iStent is a tiny implant that is inserted to improve aqueous humor drainage.

Hydrus Microstent: This procedure involves placing a small tube-like device into Schlemm’s canal (a drainage channel in the eye) to facilitate better fluid flow.

Xen Gel Stent: A gelatin tube is inserted into the subconjunctival space to create a new drainage pathway for excess fluid.

CyPass Micro-Stent: This stent is implanted into the supraciliary space to improve fluid outflow.

These procedures are generally considered safer than traditional glaucoma surgeries, such as trabeculectomy or tube shunt procedures, as they involve fewer complications and have a lower risk of serious side effects. However, the effectiveness of MIGS procedures may vary depending on the severity and type of glaucoma.

MIGS procedures generally take 8 minutes to 20 minutes to complete depending on the type of procedure. Many of the above MIGS procedures are done in combination with cataract surgery. 

How Long Does A Trabeculectomy Take?

A trabeculectomy is a surgical procedure used to treat glaucoma. It is a traditional glaucoma surgery that aims to lower intraocular pressure (IOP) by creating a new drainage channel for aqueous humor to exit the eye. This procedure is typically performed when other treatments, such as medications or laser therapy, have failed to effectively control the glaucoma or when the condition is advanced.

How Is A Trabeculectomy Done?

During a trabeculectomy, the surgeon creates a small flap in the sclera (the white part of the eye) and removes a small piece of the trabecular meshwork and underlying tissue. The trabecular meshwork is the natural drainage structure in the eye that regulates the outflow of aqueous humor. By removing a portion of it, the surgeon creates a new opening through which fluid can drain more freely.

The surgeon then creates a small reservoir or “bleb” underneath the conjunctiva (the thin, transparent tissue covering the sclera) to collect the draining fluid. The bleb acts as a reservoir to control the flow of aqueous humor and reduce the intraocular pressure.

To regulate the drainage and prevent excessive fluid loss, the surgeon may also place a small tube or sutures called “suturing techniques” during the surgery. These techniques help to control the rate of fluid drainage and maintain appropriate IOP levels.

How Long Does A Trab Take?

The trabeculectomy glaucoma surgery usually takes anywhere from 30 minutes to 60 minutes depending on the patient’s eye tissue. If it is being done with cataract surgery it could take longer. 

How Long Does Glaucoma Tube Surgery Take?

Glaucoma tube surgery, also known as a glaucoma drainage device implantation, is a surgical procedure performed to manage glaucoma and lower intraocular pressure (IOP). It is typically considered when other treatments, such as medications, laser therapy, or trabeculectomy, have not effectively controlled the glaucoma or when the condition is advanced.

How Is A Tube Done?

During a glaucoma tube surgery, a small tube or implant called a glaucoma drainage device or tube is inserted into the eye to create a new drainage pathway for the aqueous humor (the fluid inside the eye). The tube is typically placed in the anterior chamber of the eye or in the space between the layers of the eye, depending on the specific type of device being used.

The most commonly used glaucoma drainage devices are the Ahmed valve and the Baerveldt implant. These devices consist of a small tube connected to a plate or reservoir, which helps regulate the flow of aqueous humor and control the intraocular pressure.

The surgery typically involves making a small incision in the eye, creating a pocket or tunnel in the conjunctiva (the thin, transparent tissue covering the sclera), and inserting the tube into the eye. The plate or reservoir portion of the device is positioned underneath the conjunctiva to collect the aqueous humor and allow it to drain. The incision is then closed, and the conjunctiva is usually sutured back in place.

The glaucoma drainage device helps to divert the excess fluid in the eye, allowing it to bypass the trabecular meshwork (the natural drainage structure of the eye) and flow out of the eye through the tube. By providing an alternative drainage pathway, the device helps to lower intraocular pressure and manage glaucoma.

How Long Does Glaucoma Tube Surgery Take?

Ahmed valve surgery usually takes 20 minute to 60 minutes depending on where in the eye the valve needs to be placed as well as the patient’s eye tissue. In eyes that have had multiple other surgeries, the surgery could take longer and be more complicated. Also in eyes that have severe diabetes, the surgery could be more complicated and take longer.

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