Glaucoma Surgery
Treat Glaucoma with eye surgery at Green Apple Eye Care
Glaucoma can be effectively treated with eye surgery, and our glaucoma surgeon, Dr. Memmen, is world renowned for his expertise at many surgical procedures including selective laser trabeculplasty, trabeculectomy and EX-PRESS Glaucoma Filtration Device surgery.
When is open-angle glaucoma surgery necessary?
As with any surgery, no matter how simple or routine, there are always inherent risks. However, those risks should be discussed with Dr. Memmen and balanced against the greater risk of leaving glaucoma untreated and losing your vision.
Surgery Options:
Trabeculectomy

Before Surgery: You will continue to use your glaucoma medications until just prior to surgery, as directed by Dr. Memmen. The precise timing for stopping and resuming all of your other medications including Coumadin or any anticoagulants, and aspirin or any products containing aspirin should be coordinated with your internist, cardiologist and ophthalmologist.
You will be unable to drive after surgery, so you will need to arrange for transportation home.
You may expect significant blurring or fogging of your vision in the early post-opertative stages. Daily fluctuation in your vision after surgery is also expected. Generally, you will see gradual improvement of your vision over several weeks. There may or may not be a change in your eyeglass prescription after surgery. Vision may not return to “normal” if a cataract is present or another complication exists. Dr. Memmen will discuss your personal expectations and likely visual results. Surgery can prevent further damage caused by glaucoma but it cannot usually restore vision already lost from glaucoma.
While complications during a trabeculectomy are very rare, some risks include:
- scarring
- infection
- bleeding
- wound leakage
- over filtration
- loss of vision
- premature development of a cataract
Although the success rate is quite high, sometimes a single surgical procedure cannot halt the progression of glaucoma. Another surgery, continued treatment with medications, or both may be necessary.
An eye that has undergone a trabeculectomy and has a functioning bleb will always be susceptible to infection. A red, uncomfortable eye may be a sign of infection and requires urgent medical attention.
Selective Laser Trabeculoplasty (SLT)

After a successful SLT, many patients continue to use eyedrops to maintain a safe intraocular pressure. This procedure is typically not used as a long-term or permanent solution because, over time, eye pressure may return to increased levels. By five years, up to half of people treated with SLT experience a rise in eye pressure. Dr. Memmen will need to continue to monitor your eye pressure and can repeat the SLT treatment if needed.
However, this laser surgery can reduce the amount of medication you need and is often recommended as a first line of glaucoma treatment for those who have trouble using eye drops.
Your vision will be blurred immediately after treatment but should clear within just a few hours. Most people can return to their normal activities the day after the glaucoma laser surgery.It will take several weeks for the laser treatment to take full effect. Dr. Memmen will want to check your eye pressure one to two months after the procedure. If your eye pressure is not lower at the first visit, some additional effect can be gained up to three months after treatment.
If lower eye pressure needs to be attained, Dr. Memmen will help you decide whether additional laser treatment, medication, or surgery is required.
Although rare, possible complications include:
- Failure to adequately lower the eye pressure
- Inflammation in the eye causing pain, redness, or blurred vision
Aqueous Shunt Surgery
The Ex-PRESS mini-shunt is a relatively new device, available in the USA since 2002. Over 12,000 implantations have been performed worldwide. It is a straightforward procedure in which Dr. Memmen diverts the fluid through an extremely small tube to the outside of the eye. He neither cuts the sclera, nor the iris. Although the device is as small as a grain of rice, it acts just like a heart stent, keeping a pathway open so blood (or fluid) can successfully go around the blockage.
The Ex-PRESS provides precise control of the amount of fluid that is allowed to flow out, helping the eye maintain a healthy level of internal pressure. The shunt provides effective long term control of intraocular pressure, with a success rate of about 94%. It can be done following, or along with, cataract surgery.
The Ex-PRESS has an equally effective intraocular pressure control compared with trabeculectomy, but is safer than trabeculectomy in the short term. In most cases, patients virtually eliminate their need for glaucoma eye drops after surgery.
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