Will you please tell me the name of the filtering surgery for glaucoma, and explain it to me? I have had glaucoma for 25 years and am unable to take Alphagen, so my ophthalmologist wants me to have this operation to bring down my pressures. I am now taking Cosoft and Xalatan.

Marie

Glaucoma is a condition in which the pressure in the eye becomes elevated, causing damage to the optic nerve. If untreated, it can lead to serious vision loss and even blindness. The most common type of glaucoma, called primary open-angle glaucoma, occurs when the eye's internal drainage system loses its effectiveness, for reasons we still do not fully understand. Among those at increased risk of glaucoma are African Americans, the elderly and people with a family history of glaucoma. Other risk factors include smoking, use of steroid medications and trauma to the eye.

The doctor has the choice of treating glaucoma with eyedrops, laser therapy or traditional surgery. The decision about how to treat glaucoma in a certain patient depends on an evaluation of that individual's eye pressure and optic nerve health.

Over the past five years, a number of new, powerful glaucoma medications have been developed that alone or in combination can often keep the eye pressure at an appropriate level. Laser surgery is also a safe and simple method of lowering eye pressure, but its effects often wear off after five to seven years. For patients with glaucoma that cannot be controlled with medications or laser therapy, the best option may be traditional surgery.

The most common type of glaucoma surgery in the United States is trabeculoplasty. In this surgery, also called a "filtering procedure," the eye surgeon makes a tiny opening between the inside of the eye and the white part of the eye. This allows excess fluid to filter out of the eye, thereby lowering pressure levels within the eye. The actual surgical procedure takes between 30 minutes and one hour. It is done on an outpatient basis, so most patients are able to go home the same day.

Filtering surgery has a high success rate, and many patients are able to stop their glaucoma eyedrops after surgery. Of course, as with any surgical procedure, there are risks, including the possibility of bleeding and infection. In rare cases, complications can lead to blindness. So, it is important that you talk to your doctor about whether the benefits of filtering surgery (lowering the eye pressure) outweigh the risks of possible vision loss.