GLAUCOMA SERVICES
Interventional Glaucoma Care
A proactive approach that considers laser and minimally invasive procedures earlier—before glaucoma progresses or daily treatment becomes unnecessarily burdensome.
A MORE PROACTIVE APPROACH
What does “interventional glaucoma” mean?
Traditional glaucoma care often begins with one or more daily eye drops, followed by laser or surgery if pressure remains uncontrolled. Interventional glaucoma broadens that sequence. It considers office-based laser and minimally invasive glaucoma surgery earlier when those options fit the patient’s anatomy, disease stage, pressure goal, lifestyle, and preferences.
This does not mean that every patient needs a procedure or that eye drops are no longer useful. It means discussing the full range of effective options early and choosing a plan that protects the optic nerve while minimizing treatment burden when possible.
POTENTIAL BENEFITS
Why consider an interventional approach?
Less dependence on daily drops
Laser or MIGS may reduce the number of medications needed. Some patients may be able to remain drop-free for a period of time, although results vary.
More consistent treatment
A procedure does not depend on remembering a bottle every day, which can reduce the effect of missed doses or difficulty using drops correctly.
A healthier ocular surface
Fewer topical medications may lessen dryness, redness, irritation, allergy, or preservative exposure for some patients.
Earlier pressure control
Treating the drainage system earlier may help reach an individualized target pressure before additional optic-nerve damage occurs.
Opportunity during cataract surgery
Many minimally invasive glaucoma procedures can be performed at the time of cataract surgery through the same small incision.
Tissue-sparing options
Many MIGS procedures preserve the conjunctiva and may leave additional treatment choices available if glaucoma progresses later.
Personalized care
The plan can combine observation, drops, laser, sustained treatment, cataract surgery, MIGS, or traditional surgery based on the eye—not a fixed sequence.
Ongoing protection
Procedures are paired with continued pressure checks, OCT imaging, and visual-field testing so treatment can be adjusted over time.
PROCEDURAL OPTIONS
Interventional treatments we may discuss
Selective laser trabeculoplasty (SLT)
An office-based laser treatment that improves drainage through the trabecular meshwork. It may be used first-line or alongside drops for open-angle glaucoma or ocular hypertension.
Laser peripheral iridotomy (LPI)
Creates a microscopic opening in the iris to reduce the risk of angle closure or treat certain narrow- or closed-angle conditions.
Canaloplasty and goniotomy
Microsurgical procedures that open, widen, or bypass resistance within the eye’s natural drainage pathway. They may be performed with cataract surgery or in selected standalone cases.
Trabecular micro-bypass procedures
Tiny implants or internal drainage procedures may improve fluid outflow and reduce pressure or medication burden in appropriately selected eyes.
Cyclophotocoagulation
Laser energy reduces fluid production. Modern approaches may be considered across a broader range of glaucoma severity when clinically appropriate.
Traditional glaucoma surgery
Trabeculectomy or a tube shunt may be recommended when advanced glaucoma requires a lower target pressure than less invasive options are likely to achieve.
SLT can be an initial treatment—not only a “last step”
Large randomized studies support SLT as a safe and effective first treatment for many patients with open-angle glaucoma or ocular hypertension. It can also be used after drops or repeated when clinically appropriate. Your drainage angle and glaucoma type determine whether SLT is an option.
WHO MAY BENEFIT?
Candidacy depends on more than one pressure reading
An interventional option may be worth discussing if you:
- Have ocular hypertension or open-angle glaucoma
- Are not reaching target pressure with the current plan
- Have difficulty remembering or administering drops
- Experience dryness, redness, allergy, or other medication side effects
- Need cataract surgery and also have mild or moderate glaucoma
- Want to understand options that may reduce medication burden
Your doctor will also consider:
- Glaucoma type and severity
- Drainage-angle anatomy
- OCT and visual-field changes over time
- Current and previous eye-pressure measurements
- Corneal thickness and optic-nerve appearance
- Prior laser, surgery, or eye trauma
- Cataract status and your individualized target pressure
WHAT TO EXPECT
A step-by-step treatment plan
1. Comprehensive testing
We confirm the glaucoma type and stage using pressure measurements, gonioscopy, optic-nerve examination, OCT, visual fields, and other testing as needed.
2. Shared decision-making
Your physician explains the reasonable options, expected pressure reduction, recovery, risks, alternatives, and whether medication may still be needed.
3. Procedure and follow-up
Treatment is followed by pressure checks and healing assessments. Instructions vary depending on whether the procedure is office-based or performed in the operating room.
4. Long-term monitoring
Glaucoma remains a lifelong condition. OCT, visual fields, optic-nerve examinations, and pressure trends show whether the plan is protecting vision.
IMPORTANT LIMITS
What these procedures can—and cannot—do
Interventional treatment is intended to lower eye pressure and reduce the risk of additional optic-nerve damage. It cannot restore vision already lost to glaucoma. No procedure guarantees freedom from eye drops, and some patients eventually need repeat laser, additional medication, or another operation. Recommendations are individualized after examination.
COMMON QUESTIONS
Interventional glaucoma FAQ
Is SLT painful?
Numbing drops are used, and most patients experience little or no discomfort. Temporary blur, irritation, inflammation, or a pressure rise can occur.
Will I be able to stop my drops?
Possibly, but not always. The goal may be fewer drops, a lower pressure, or better disease stability rather than eliminating medication completely.
Is MIGS only performed with cataract surgery?
Many MIGS procedures are combined with cataract surgery, while selected procedures may also be performed on their own.
Does MIGS replace trabeculectomy or tube surgery?
No. Traditional surgery remains important when glaucoma is advanced or a very low target pressure is needed.
LEARN MORE
Understand glaucoma testing and long-term care
Visit our patient education page for a broader explanation of glaucoma types, warning signs, diagnostic testing, and ongoing monitoring.