What are your results like for glaucoma treatment?
What are my results like for glaucoma treatment? Unlike cataract surgery, where you get a visual result quickly after the operation, some glaucoma treatment results are built up over time and individualised to the patient.
I don’t provide a general answer for all glaucoma patients. I like to frame the response for the individual based on the type of glaucoma they have and the severity of the disease.
Depending on the treatment it can take different time frames to get results, and it also depends on which result you are measuring. The following are guidelines:
- Medical treatments work fairly quickly – within hours to days – to lower intraocular (eye) pressure.
- A laser treatment called a laser peripheral iridotomy can produce the result of opening up the drainage angle within hours to days in about 80% of eyes treated. You still need monitoring afterwards to see if the result has maintained because the effect can wear off.
- Another laser treatment called selective laser trabeculoplasty can take a few months to measure the full effect of reducing the intraocular (eye) pressure. The procedure is effective in about 70% of patients, but it can wear off with time.
- A surgical treatment called trabeculectomy can work straight away to reduce the intraocular (eye) pressure. However, it needs careful monitoring afterwards to assess that this effect is optimised and maintained. This treatment is effective in about 75 to 80% of the eyes treated however the effect can wear off with time.
- Another surgical treatment called microinvasive surgery (also called iStent® implantation) can work within a week or so, although it can take a few months to measure the full effect. This treatment works by reducing eye pressure and reducing some of your eye medication. It can be effective in about 60 to 70% of the eyes treated. Again, you still need monitoring afterwards to see if the result has maintained.
The mainstay of glaucoma treatments is to reduce intraocular (eye) pressure to slow down or stop the disease worsening. The above guidelines refer to the result of measuring whether the treatment achieves a reduction in intraocular (eye) pressure. In glaucoma, we are also interested in measuring other outcomes, including whether the metrics measuring the structure and visual function of the eye are stable. This takes a longer time period to measure, sometimes several years (e.g. two years) after getting the eye pressure reduced to see what these results are.
That’s why it’s important to regularly review a patient over a fair amount of time to be able to measure these outcomes and to give patients a better understanding of what their final visual health will be.