Angle-closure Glaucoma Surgery: Book Free Consultation

Angle-closure glaucoma is a severe eye condition that can result in vision loss if left untreated. Fortunately, advanced surgical intervention can relieve the pressure caused by the condition and prevent further damage. Learn about this effective treatment, its benefits, risks, and potential complications in this article. If you are struggling with symptoms of this condition, don't hesitate to contact Pristyn Care and book an appointment with an experienced ophthalmologist today.

Angle-closure glaucoma is a severe eye condition that can result in vision loss ... Read More

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What is Angle-closure Glaucoma Surgery?

Angle-closure glaucoma surgery is a procedure performed by an ophthalmologist (eye doctor) to treat the chronic or acute form of this eye condition. In angle-closure glaucoma, the drainage angle formed by the iris and cornea gets blocked, leading to increased intraocular pressure (IOP). This increased pressure could lead to severe damage to the optic nerve, potentially leading to vision loss.

The purpose of angle-closure glaucoma surgery is to alleviate this elevated IOP and restore normal drainage of aqueous humor—the clear fluid that fills the frontal part of your eye. It is an outpatient procedure, which means you will not require hospitalization. The types of surgery vary depending on the severity of the condition and other individual factors, but all aim to restore proper drainage and lower IOP.

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What Are The Types Of Angle-closure Glaucoma Surgery?

The types of surgeries for angle-closure glaucoma vary according to each patient’s individual needs and circumstances. Here are the main types of surgeries:

Laser Iridotomy: This procedure involves using a laser to create a small hole in the peripheral iris. It allows aqueous humour (the clear liquid inside the eye) to flow freely, reducing pressure and preventing future blockages.
Surgical Iridectomy: In cases where laser treatment isn’t appropriate (e.g., due to corneal opacity), a surgical iridectomy may be performed. This involves making a small incision in the iris to remove a portion of it and unblock the drainage angle.
Laser Iridoplasty: Here, laser energy is used to create burns in the peripheral iris, causing the tissue to contract and pull the iris away from the drainage angle.
Trabeculectomy: In advanced cases of angle-closure glaucoma, a trabeculectomy might be required. This surgery creates a new drainage pathway for aqueous humour, helping lower IOP significantly.
Synechialysis: If the iris has adhered to the drainage angle due to prolonged blockage, synechialysis may be performed. It breaks the adhesions and restores normal fluid flow.

Diagnosis Before Chronic Angle-Closure Glaucoma Surgery

A comprehensive assessment by your doctor is required to confirm if you have chronic angle-closure glaucoma before you undergo surgery. Your doctor will typically conduct the following tests:

Patient History and Symptoms: The doctor evaluates your existing symptoms, which could range from blurred vision, mild discomfort, to occasional headaches.
Intraocular Pressure Measurement: An important step in this process is measuring the pressure in your eye, as higher intraocular pressure (IOP) is one of the key indicators of glaucoma.
Gonioscopy: A crucial examination, gonioscopy allows the doctor to inspect the anterior chamber angle and identify any presence of peripheral anterior synechiae (PAS), which are adhesions obstructing fluid drainage.
Optic Nerve Examination: Doctors look for signs of damage to the optic nerve that could denote glaucomatous changes. This may involve scanning techniques to measure the cup-to-disc ratio and evaluate the optic nerve head.
Visual Field Testing: Testing your peripheral vision aids in detecting any defects indicative of damage to the optic nerve.
Assessment of Anterior Chamber Depth: The depth of the anterior chamber can be determined by using a slit lamp or penlight to check if the angle is narrow, thereby predisposing you to angle closure glaucoma.

What Is The Procedure For Angle-Closure Glaucoma Surgery?

The angle-closure glaucoma surgery procedure generally involves the following steps:

Initial Assessment: A thorough eye examination is conducted to confirm the diagnosis of angle-closure glaucoma and assess the condition’s severity.
Sterilisation: The face is cleaned, and povidone-iodine eye drops are administered to sterilise the eyes. The skin around the eye is also cleaned with povidone-iodine.
Medication Administration: Preoperative medications, including topical IOP-lowering drops, may be given to stabilise the intraocular pressure before surgery.
Incision Construction: Depending on the surgical technique chosen (e.g., laser iridotomy or surgical iridectomy), the surgeon will make an incision in the appropriate location to access the anterior chamber.
Iris Manipulation: A portion of the iris will be removed to create a new opening for aqueous humour to flow, alleviating the pressure buildup.
Fluid Management: During the procedure, the surgeon will carefully manage the anterior chamber’s pressure and fluid dynamics to prevent complications.
Closure: After the necessary surgical interventions, the incision will be closed, often without sutures, relying on the self-sealing properties of the corneal tissue.

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Who Is The Right Candidate For Angle-Closure Glaucoma Surgery?

The decision to undertake angle-closure glaucoma surgery is based on your symptoms, condition of your eyes, and overall health. If you’re considered a suitable candidate for this surgery, it could be due to:

Elevated Intraocular Pressure: This procedure could be considered if your eye pressure is significantly high, and the usual treatment methods have not yielded desired results.
Optic Nerve Damage: If tests show damage to your optic nerve due to high eye pressure, surgical intervention may be required.

Narrow Angles: If you have narrow angles that make you prone to angle-closure glaucoma or if you have already experienced an acute attack of angle closure, you may be advised surgery.

What Are The Benefits Of Angle-closure Glaucoma Surgery?

Undergoing an angle-closure glaucoma surgery can seem daunting. However, this procedure has numerous benefits that can significantly enhance the patient’s quality of life. Here are some advantages:

Improved Intraocular Pressure Control: This surgery can significantly lower intraocular pressure (IOP), decreasing the risk of optic nerve damage and maintaining vision.
Reduced Medication Dependence: After surgery, patients often need fewer glaucoma medications, which means better adherence and improved quality of life.
Enhanced Quality of Life: Patients may experience fewer symptoms such as blurred vision, headaches, and eye discomfort after a successful operation.
Cost-Effectiveness: In the long run, surgical intervention can be more cost-effective compared to ongoing medication management.

How To Prepare For Angle-closure Glaucoma Surgery?

Preparing properly for an angle-closure glaucoma surgery is important to ensure its success. Here’s how to prepare:

Preoperative Assessment: A comprehensive eye examination and assessment of medical history are essential. It includes measuring IOP, performing a gonioscopy, and evaluating the optic nerve.
Medication Review: Patients must inform their doctor about all medications they are currently taking, including over-the-counter drugs and supplements.
Fasting: Especially if sedation or general anaesthesia is planned, patients might need to fast for a certain period before the surgery.

What Are The Recovery Tips and Precautions To Follow After Angle-closure Glaucoma Surgery?

The recovery period following an angle-closure glaucoma surgery requires care and patience. Here are some tips for a smooth recovery:

Follow-Up Appointments: Regular follow-ups with the ophthalmologist are crucial to monitor IOP and assess the success of the surgery.
Medication Compliance: Patients may be prescribed eye drops or medications to manage inflammation and prevent infection. Following this regimen precisely is crucial.
Avoid Strenuous Activities: Patients should avoid heavy lifting, vigorous exercise, or activities that might strain the eyes for a few weeks after the surgery.
Protecting the Eyes: Wearing sunglasses outdoors can help protect the eyes from bright light and dust.

Watch for Symptoms: Patients should stay vigilant for any signs of complications, such as increased pain, redness, or vision changes, and report these to their doctor immediately.

Potential Risks Or Complications Associated With Angle-closure Glaucoma Surgery

Like all surgical procedures, angle-closure glaucoma surgery carries some potential risks and complications. Here are a few to consider:

Infection: There is always a risk of infection in any surgical procedure, which can lead to further complications if not treated promptly.
Bleeding: Some patients may experience bleeding in the eye, which could potentially affect vision.
Intraocular Pressure Fluctuations: While surgery aims to lower IOP, in some cases patients may experience fluctuations that require additional treatment.
Vision Changes: There could be temporary or, in rare cases, permanent changes in vision after the surgery.

Cataract Formation: Surgery can sometimes lead to cataract formation requiring further surgical intervention.

What Is The Cost Of Angle-closure Glaucoma Surgery In India?

The cost of angle-closure glaucoma surgery in India spans a wide range, starting from around Rs. 26,000 and going up to approximately Rs. 1,70,000. This significant variation in costs is due to the numerous influencing factors, such as:

Type of Surgery: Depending on the specific procedure required for the treatment of angle-closure glaucoma, the cost can vary considerably.
Surgeon’s Expertise: Experienced and renowned surgeons often charge more for their services owing to their expertise in the field.
Choice of Hospital: Hospitals with advanced technology and a broader reputation tend to charge higher fees compared to smaller clinics or public hospitals.
Geographic Location: The cost of healthcare services is generally higher in major cities due to elevated living and operational costs.
Diagnostic Tests: Before surgery, diagnostic tests like tonometry, gonioscopy, or OCT add to the overall cost.
Postoperative Care: Expenses related to follow-up consultations, medications, or additional treatments after surgery contribute to the total cost.
Complications: Any complications that arise during or after surgery could lead to unexpected costs due to additional medical attention necessary.

Is Angle-closure Glaucoma Surgery Covered Under Insurance?

Angle-closure glaucoma surgery is a medically necessary procedure and hence is covered under many health insurance plans in India. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme even includes such surgery in its package, offering financial protection up to Rs. 5 lakh per family per year for necessary hospitalisation.

Typically, coverage details can include costs of the surgery itself, pre-operative and post-operative appointments, diagnostic tests, hospital stay, and fees for anaesthesia and the surgeon. However, exclusions may apply to pre-existing conditions subject to a waiting period, treatments deemed experimental or cosmetic in nature, or any complications resulting from negligence.

Always consult with your eye specialist and insurance provider to understand exactly how much coverage you can expect for angle-closure glaucoma treatment. Be sure to enquire about any potential exclusions related to your specific situation.

FAQs

What are common signs that may indicate complications after angle-closure glaucoma surgery?

Post-surgery complications can be signalled by severe pain, a significant decrease in vision, persistent redness of the eye, or excessive discharge from the eye. If you experience these symptoms, seek immediate medical attention.

Can angle-closure glaucoma surgery be performed on both eyes at once?

Typically, doctors prefer to operate on one eye at a time to reduce potential risks and complications. The decision depends on the severity of the condition in both eyes and the overall health status of the patient.

What is the success rate of angle-closure glaucoma surgery?

The success rate of angle-closure glaucoma surgery varies depending on individual cases and the specific type of surgical procedure utilised. However, it generally has a high success rate, with a significant proportion of patients experiencing improvement in their condition post-surgery.

Are there any alternative treatments to angle-closure glaucoma surgery?

Yes, there are alternatives, such as laser treatments and medication. However, in severe cases or where these treatments have failed, surgery might be the only viable option to prevent further damage or loss of vision.

Will my vision be fully restored after the angle-closure glaucoma surgery?

The surgery primarily aims to prevent further damage and loss of vision. Complete restoration of your vision will depend on the extent of damage prior to the operation and how well your eyes respond to the surgery.

How long does it take for an eye to heal after angle-closure glaucoma surgery?

Healing time varies from person to person but generally, you should start noticing improvements within a few weeks from the surgery. Complete healing may take several months.

Is it normal to experience pain or discomfort after angle-closure glaucoma surgery?

It is normal to experience mild discomfort or a gritty sensation in your eye after surgery. Pain should not be severe and if you do experience intense pain, you should contact your doctor immediately.

Can I go back to my regular activities soon after the angle-closure glaucoma surgery?

You will need to avoid certain activities like heavy lifting, straining or any activity that increases pressure on the eyes for a few weeks post-surgery. Your doctor will advise you on when you can get back to your routine.

Are there any lifestyle changes I should make post angle-closure glaucoma surgery?

Your doctor may advise you to make certain lifestyle changes post-surgery, like avoiding strenuous activities, taking prescribed medications regularly, and attending regular check-ups.

Will I need repeated surgeries for angle-closure glaucoma?

This greatly depends on the individual case. Some patients may require more than one surgery if their condition does not improve or if the symptoms return in the future.

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