When SLT, glaucoma medications, and other treatments do not lower eye pressure to the desired level, your doctor may recommend some form of incisional surgery. This surgery is done in a hospital or surgery center, using a microscope and microsurgery instruments, and includes making a cut (incision) in the eye.

In incisional surgery, also called filtering surgery, a tiny drainage hole is made in the sclera (the white part of the eye) in a procedure called a trabeculectomy or a sclerostomy. The new drainage hole allows fluid to flow out of the eye and helps lower eye pressure. This prevents or reduces damage to the optic nerve.

What to expect:

Before surgery begins, a local anesthetic along with a medication to help you relax is given to prevent you from feeling any discomfort during the procedure.
During surgery, the doctor looks through a microscope that is placed several inches above your eye.
Eye surgery does require some recovery time, which will vary according to your age, daily activities, and other personal factors. Most people can move around and return to their normal activities soon after going home, though you may have to wear an eye patch to protect your eye.
For at least a week after glaucoma surgery, it is advisable to keep water out of the eye. It is also good to take a break from driving, reading, bending, and strenuous exercise.
Glaucoma surgery may have to be repeated, especially if excessive scarring cannot be prevented or after long periods of time.

After surgery, you may need to change your contact lenses or glasses. Gas permeable or soft contact lenses may be worn. However, the bleb may cause fitting problems, and special care will be needed to avoid infection of the bleb. Contact lens users should discuss these problems with their eye doctor following surgery.