Glaucoma Drainage Surgery in Turkey: Types, Cost, Recovery and More

Glaucoma is a serious eye condition characterized by progressive optic nerve damage due to increased intraocular pressure (IOP).
Glaucoma treatment aims to reduce IOP, slow vision deterioration, and protect the optic nerve.
However, treatment cannot reverse nerve damage or restore lost vision.

Treatment options include medications, laser therapy, and surgery.
In this article, we will focus on the surgical option, providing detailed information about the procedure, recovery, and cost.

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What is Glaucoma Drainage Surgery

Glaucoma surgery is a minor procedure usually performed under local anesthesia. Its goal is to eliminate the excess aqueous humor, minimizing elevated intraocular pressure and the risk of optic nerve damage.

How Does Glaucoma Surgery Work?

Glaucoma surgery works by enhancing fluid drainage. Depending on the type of procedure, this can be achieved through:

1. Creating a new drainage pathway to facilitate the outflow of aqueous humor.

2. Removing the functionally ineffective parts of the meshworks, the system responsible for fluid drainage

3. Widening the drainage angle to improve natural fluid outflow.

4. A drainage device should be implanted to help reduce pressure buildup in the eye.

Glaucoma Surgery Pros and Cons

Pros: 

1. More effective in reducing intraocular pressure, especially in severe or refractory cases.

2. Can provide long-term results compared to other treatments.

Cons:

A surgical procedure that carries risks such as infection, bleeding, or excessive lowering of intraocular pressure.

A Longer recovery period compared to other glaucoma treatment options.

Higher cost than other glaucoma treatment options

Require long-term follow-up, and may have prolonged recovery time.

When Do You Need Glaucoma Surgery?

A doctor decides to perform glaucoma surgery when other treatments, such as medications and laser treatment, fail to control intraocular pressure (IOP) effectively. 

Surgery is usually recommended for advanced or refractory glaucoma, cases with progressive vision loss, or when the IOP remains dangerously high despite treatment. 

The decision also depends on the patient’s overall eye health and the risk of further optic nerve damage.

Before deciding on surgery, patients undergo several tests to evaluate the severity of glaucoma and determine the most suitable treatment. 

Some of the key tests include the fundus test, corneal thickness measurement, and the Stratus OCT (Optical Coherence Tomography)

Types of Glaucoma Drainage Surgery

The type of surgery is determined depending on the type of glaucoma, the severity of the condition, along with other factors based on the patient such as the cost of the surgery, like the surgery; some patients may feel discomfort placing a shunt or a device inside the eye.

The ophthalmic surgery usually discusses with the patients all options available and shares with them the decision.

Glaucoma drainage surgery options include:

Glaucoma Filtering Surgery ( Trabeculectomy)

Glaucoma filtration surgery, also known as trabeculectomy, is the most common surgery for open-angle glaucoma. 

It helps the eye drain liquid more effectively and lower intraocular pressure. 

In the trabeculectomy, 

The eye surgeon makes a small flap in the sclera, the white visible part of the eye, or under the eyelid,  to create a new pathway for fluid inside the eye to be drained.

This tiny opening lets fluid move freely and helps to bypass the natural drainage system of the eye to lower eye pressure.

This type of surgery is usually used to treat open-angle glaucoma, 

it is performed under local anesthesia, so the patient will be awake but will not feel any pain or discomfort

Glaucoma Implant Surgery and Drainage Devices (Shunt)

This surgery involves placing a small device, called an implant or shunt, in the eye to treat glaucoma. 

There are several types of glaucoma drainage implants, they all have a soft, flexible tube connected to a thin, curved plate that rests comfortably on the sclera (the white part of the eye). 

The tube is inserted, through a small opening, into the anterior chamber, the front part of the eye where the cornea and sclera meet, to allow excess fluid to drain. 

This tube helps extra fluid drain out of your eye into a small area under the outer layer of the eye, where the body gradually absorbs it, lowering eye pressure.

This type of surgery is used to treat several types of glaucoma, including congenital glaucoma, neovascular glaucoma, and glaucoma caused by an injury. 

It is performed under local anesthesia and takes about 1 to 2 hours.

Minimally Invasive Glaucoma Surgery (MIGS)

Minimally Invasive Glaucoma Surgery (MIGS) is a technique that uses tiny instruments and devices to create small incisions and precisely target drainage areas in the eye. 

Because the incisions are smaller, recovery is usually faster, and treatment can be done earlier in the disease. 

This approach is mainly recommended for mild to moderate glaucoma, especially for patients who struggle with regular medication use but do not yet require traditional invasive surgery.

Common MIGS procedures include:

• Intent
• Hydrus stent
• Preserflow shunt

Benefits of Using Minimally Invasive Glaucoma Surgery (MIGS)

Micro-invasive or minimally invasive glaucoma surgery (MIGS) offers numerous benefits including:

1. High safety with a reduced risk of complications.

2. Minimal disruption to the eye’s natural drainage system.

3. Effective alternative to traditional glaucoma surgery.

4. Faster recovery with minimal downtime.

5. simple instrumentation.

Traditional Glaucoma Surgery vs. Minimally Invasive Glaucoma Surgery

Effectiveness: Traditional glaucoma surgeries are generally more effective in significantly lowering IOP, making them suitable for advanced cases. 

Safety: MIGS offers a safer alternative with quicker recovery for patients with mild to moderate glaucoma, although the extent of IOP reduction may be less pronounced. 

The choice between MIGS and traditional surgery should be based on individual patient factors, including the severity of glaucoma, IOP targets, and overall health.

Glaucoma Surgery vs. Laser Treatment for Glaucoma

1. Safety: Laser treatment for glaucoma is safer and has fewer side effects, with a lower risk of complications during and after the procedure.

2. Effectiveness: Traditional surgery is more effective for treating severe and refractory glaucoma. It can lower intraocular pressure (IOP) by a greater percentage compared to laser treatment.

3. Cost: Laser treatment for glaucoma is more affordable than traditional surgery.

4. Recovery Time: Laser treatment allows for a faster recovery period compared to conventional eye surgery.

Glaucoma Surgery Procedure

1. preparation for the surgery:

During the  surgery preparation, an initial consultation is essential, in which the surgeon makes several eye pressure measurements, takes your medical history, and provides you with pre-operative instructions 

These instructions include:

1. NSAIDs, aspirin, or other blood thinners to reduce the risk of bleeding.

2. Arrange for someone to drive you if you’ll receive sedation or anesthesia.

3. Confirm which medications you can take before the procedure.

4. Follow fasting instructions based on the anesthesia type.

2. During the procedure:

During the surgery, you'll receive anesthesia to keep you comfortable. 

The surgeon starts by making a small incision, and what happens next depends on the type of procedure. In trabeculectomy, they create a tiny opening under your eyelid to help drain fluid. 

If you're getting an implant-based surgery, they'll place a small shunt to redirect the fluid and lower your eye pressure.

How long does glaucoma surgery take?

The duration of glaucoma surgery depends on the type of procedure. Minimally invasive glaucoma surgeries (MIGS) typically take 10 to 30 minutes, while traditional procedures like trabeculectomy for glaucoma drainage implant surgery can take 45 minutes to 2 hours.

3. After the procedure:

After the procedure, your eye may feel a bit sore or irritated, and your vision might be blurry for a short time. 

Your doctor will give you eye drops to help with healing and prevent infection. It’s important to avoid rubbing your eye, lifting heavy objects, or doing anything that could strain your eye while it heals. 

You’ll also need to attend follow-up appointments to make sure your eye pressure is improving and that everything is healing as expected. 

If you notice any unusual pain, redness, or vision changes, contact your doctor right away.

Glaucoma Surgery Recovery

Recovery begins immediately after glaucoma surgery, but the healing process varies depending on the type of procedure. 

The initial recovery period usually lasts 3 days to a week, while complete healing can take 3 to 6 weeks.

Common side effects include mild discomfort, itching, and blurriness, which typically subside within a few days. 

During the first night, you may need to keep your eyes padded or covered with a protective shield, as instructed by your doctor. 

The shield should be worn at night for several days to prevent accidental rubbing. Follow your doctor’s instructions carefully and use all prescribed eye drops as directed.

Aftercare Tips During Recovery:

1. Avoid rubbing your eyes, as this can cause irritation and interfere with healing.

2. Avoid swimming, hot tubs, and saunas for at least 2 to 4 weeks to prevent infections.

3. Wear sunglasses outdoors to reduce sensitivity to bright light.

4. Avoid wearing face makeup around the eyes for at least 1 to 2 weeks to prevent contamination.

5. Use prescribed medications exactly as directed by your physician.

6. Wear a protective eye shield while sleeping for the first few nights.

7. Stay hydrated and avoid alcohol for a few days, as alcohol can contribute to dehydration and slow healing.

8. Get plenty of rest and avoid strenuous activities.

9. Do not drive until your doctor confirms that your vision is stable.

10. Avoid bending, straining, or lifting heavy objects to prevent increased eye pressure.

Glaucoma Surgery Complications

Glaucoma surgery is a major surgery that involves making incisions and can expose you to some rare, however, serious risks. These risks include:

1. Loss of vision

2. Eye bleeding

3. Risks of infection

4. Scar formation

5. Cataract formation

6. Hypotony: Low eye pressure.

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Cost of Glaucoma Drainage Surgery

The cost of glaucoma surgery varies depending on several factors, including the type of surgery, the clinic’s location, the surgeon’s reputation, and available offers.

The cost of trabeculectomy surgery for one eye in Turkey is about $3,500, which is cheaper than glaucoma implant surgery, which costs around $5,000 or more.

In the US, the average cost of trabeculectomy ranges between $4,000 and $7,000, while in the UK, it typically ranges between $3,800 and $7,600. 

The cost of glaucoma implant surgery is generally higher, often exceeding $10,000 in Western countries.

Sometimes, the doctor may need to combine glaucoma surgery with other procedures, such as phacoemulsification (Phaco), to remove and replace a damaged eye lens, especially if the patient has both cataracts and glaucoma.

Combining both surgeries can be more effective in reducing risks and improving visual outcomes, but it may increase the overall cost of the procedure.

Why Choose Turkey for Glaucoma Surgery

1 State-of-the-Art Facilities: Hospitals and clinics in Turkey follow strict guidelines set by JCI, WHO, and FDA, ensuring high-quality medical care and patient safety.

Expert Surgeons: Turkey has highly qualified and internationally certified ophthalmologists with extensive experience in glaucoma surgery.

Advanced Technology: Cutting-edge surgical equipment allows for safer, more precise procedures with higher success rates.

Affordable Prices: Turkey offers cost-effective treatments with various financial options, including medical packages, insurance coverage, and installment plans, making glaucoma surgery more accessible.

FAQs

Which country is best for glaucoma treatment?
Countries like the USA, UK, Germany, and Turkey are known for excellent glaucoma treatment due to advanced technology, expert surgeons, and high-quality healthcare standards. Turkey is a top choice for affordable yet high-quality care.

How much does it cost to have glaucoma surgery?
Glaucoma surgery costs vary by country and procedure type. In the USA, it ranges from $4,000 to $10,000, while in Turkey, it starts at around $3,500, making it a cost-effective option.

What is the most successful glaucoma surgery?
Trabeculectomy is the most successful traditional glaucoma surgery, effectively reducing intraocular pressure (IOP). Minimally invasive glaucoma surgery (MIGS) is also gaining popularity due to fewer risks and faster recovery.

What is glaucoma drainage device surgery?
Glaucoma drainage device surgery involves implanting a tiny tube (shunt) to drain excess eye fluid, reducing IOP and preventing optic nerve damage in severe glaucoma cases.

How long does it take to recover from a glaucoma drainage implant?
Recovery from a glaucoma drainage implant typically takes 4 to 6 weeks, with vision improvement and pressure stabilization over a few months.

What is the surgery for eye drainage?
The most common eye drainage surgery is trabeculectomy, where a small flap is created in the eye to help fluid drain and lower IOP. Drainage implants are another option.

What are the two types of surgeries for glaucoma?
The two main types are traditional glaucoma surgery (trabeculectomy and tube shunt surgery) and minimally invasive glaucoma surgery (MIGS), which has fewer risks and faster recovery