In particular cases a special surgery that implants a small plastic “valve” is recommended. These “drainage implants” allow the outflow of the aqueous humour to be carried through the tissue of the bulb of the eye and to be redirected backwards, underneath the conjunctiva, in order to decrease the intraocular pressure. It is an outpatient surgery performed under local anaesthetic (a few drops of eye-drop). This kind of operation entails a remarkable decrease of the post-operative complications and the patient can go back home the same day of the surgery. After the operation the patient may feel a foreign body in the eye that gradually fades away. No pain at all is felt, neither during the surgery nor after it.
Modern ophthalmic lasers allow to perform effective surgeries for the treatment of glaucoma. In some cases it is possible to perform a laser treatment without the need for incisions. In some other cases an eye incision is necessary to create a new drainage duct.
Nowadays we have a wide variety of medications available that can lower intraocular pressure, so we have to choose the best treatment for each patient. We have to start the treatment with the medication that lowers and keeps intraocular pressure to the right value and that, at the same time, is well tolerated by the patient (age, job, other eye or systemic pathologies, dosage).