সংজ্ঞা
Glaucoma surgery is surgery to lower pressure inside the eye.
পদ্ধতির কারণ
It is done to treat glaucoma. The inside of the eye is normally bathed by a clear fluid. The fluid flows in and out of the front chamber of the eye. In most cases of glaucoma, this fluid flows too slowly out of the eye. The fluid builds up and increases the pressure inside the eye. If this pressure is not controlled, it can cause damage to the eye and loss of vision. This surgery is done to lower the amount of pressure in the eye. Decreasing the pressure may be needed to prevent further loss of vision.
It is important to note that while glaucoma surgery may save your remaining vision, it does not improve or restore sight.
সম্ভাব্য জটিলতা
Complications are rare, but no procedure is completely free of risk. If you are planning to have glaucoma surgery, your doctor will review a list of possible complications, which may include:
- Sensitivity to light
- সংক্রমণ
- Long-term irritation and inflammation of the eye
- রক্তপাত
- দৃষ্টি ক্ষতি
- Need for more surgery
Risk factors for complications include, but are not limited to:
- স্থূলতা
- ধূমপান
- ডায়াবেটিস
- উচ্চ্ রক্তচাপ
- Heart and lung disease
- রক্তপাতের ব্যাধি
- সংক্রমণ
কি আশা করছ
পদ্ধতির আগে
আপনার ওষুধ সম্পর্কে আপনার ডাক্তারের সঙ্গে কথা বলুন। পদ্ধতির এক সপ্তাহ আগে আপনাকে কিছু ওষুধ খাওয়া বন্ধ করতে বলা হতে পারে, যেমন:
- অ্যাসপিরিন বা অন্যান্য প্রদাহ বিরোধী ওষুধ
- রক্ত পাতলাকারী, যেমন ক্লোপিডোগ্রেল (প্লাভিক্স) বা ওয়ারফারিন (কুমাদিন)
- Continue to use your eye drops, unless directed otherwise by your doctor.
- পদ্ধতিতে এবং থেকে একটি যাত্রার ব্যবস্থা করুন।
এনেস্থেশিয়া
Drops are used to numb the eye for the procedure.
Local anesthesia and sedation may be used for incisional surgery.
General anesthesia is used under some circumstances.
পদ্ধতির বর্ণনা
There are two common types of glaucoma surgery: laser and incisional.
Laser Surgery
The main types of laser surgery include:
Argon Laser Trabeculoplasty (ALT)
Argon laser trabeculoplasty (ALT) is the most common type of laser surgery. It is usually used to treat open angle glaucoma. During this procedure, you will sit facing the laser machine. The laser “spot” will be applied to a special contact lens held on the front of the eye. You may see flashes of red or green light as the laser is applied. This procedure will allow more fluid to be released and relieve some of the pressure.
Selective Laser Trabeculoplasty (SLT)
The procedure is similar to ALT. SLT has the benefit of being repeatable. ALT cannot be done more than twice.
Laser Peripheral Iridotomy (LPI)
Laser peripheral iridotomy (LPI) is frequently used to treat narrow-angle glaucoma or to prevent glaucoma attacks in patients with anatomically narrow angles. Narrow-angle glaucoma occurs when the angle between the cornea (the clear structure on the front of the eye) and the iris (the colored part of the eye) is too small. This can cause the iris to plug up so that fluid cannot flow freely. This can cause the pressure to rise to dangerously high levels very quickly. In LPI, the laser will be used to make a small hole in the iris. The hole will allow fluid to flow more freely within the eye.
Cyclophotocoagulation
Cyclophotocoagulation is used to freeze the parts of the eye that make the eye fluid. This procedure is usually done only in people who have severe damage from glaucoma and for whom other surgeries were not successful. Instead of freezing, this procedure can also be done with a laser.
Incisional Surgery (also known as Filtering Surgery)
This surgery uses tiny instruments to remove a piece from the wall of the eye. This creates a small hole, which is covered by conjunctiva (layer around the eye). The fluid can now drain out through the hole. It will then be reabsorbed into the bloodstream. This reduces the pressure in the eye. In some cases, the doctor may place a valve in the eye through a tiny incision.
Glaucoma Implants
If the above methods fail, another option is the use of implants. With implant surgery, most of the device is positioned on the outside of the eye. A small tube or filament is carefully inserted into the front chamber of the eye. The fluid drains through the tube, or along the filament, into the area around the back end of the implant. The fluid collects here and is reabsorbed. This procedure is slightly more risky than standard trabeculoplasty and should only be performed by doctors well-versed in the technique.
এতে কতক্ষণ সময় লাগবে?
The procedure usually takes less than one hour. People having the incisional procedure may need about 4-8 hours from the time of arrival until discharge.
এটা আঘাত করবে?
For most people, the local anesthesia will block pain during surgery. There may be some burning or stinging with ALT and LPI. Some people report mild discomfort during the procedures. Incisional glaucoma surgeries tend to have more discomfort after the procedure than laser procedures.
পোস্ট-প্রক্রিয়া যত্ন
কেয়ার সেন্টারে
After the procedure, you may be given:
- An eye exam
- Eye drops
- An eye patch
ঘরে
আপনার ডাক্তারের নির্দেশাবলী অনুসরণ করতে ভুলবেন না।
- If given an eye patch or bandage, wear it as directed.
- Use eye drops as prescribed. These drops will often help prevent infection and inflammation.
- Avoid activities that expose your eye to water, like swimming.
- Ask the doctor about how to wash your face and when it is safe to shower or bathe.
- Refrain from heavy lifting, straining, or driving until allowed by your doctor.
- Follow your doctor’s advice regarding resuming exercise and other activities.
আপনার ডাক্তারকে কল করুন
বাড়িতে পৌঁছানোর পরে, নিম্নলিখিতগুলির মধ্যে যে কোনও একটি ঘটলে আপনার ডাক্তারের সাথে যোগাযোগ করুন:
- Sudden and/or severe eye pain
- Loss of vision or other eyesight changes
- জ্বর এবং ঠাণ্ডা সহ সংক্রমণের লক্ষণ
- বমি বমি ভাব বা বমি হওয়া
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the eye
- ব্যথা যা আপনি ওষুধ দিয়ে নিয়ন্ত্রণ করতে পারবেন না
- কাশি, শ্বাসকষ্ট বা বুকে ব্যথা
জরুরী পরিস্থিতিতে, অবিলম্বে চিকিৎসা সহায়তার জন্য কল করুন।