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Glaucoma Tube Shunt Surgery

More about Glaucoma

What Is Glaucoma Tube Shunt Surgery?

Glaucoma tube shunt surgery is when a tube-like device gets implanted in the eye. This device needs to equalize pressure inside the eye with the pressure outside. Implanting this device is an advanced glaucoma surgery because this would be advised in patients with advanced glaucoma.

There are many devices, e.g. tubes, stents, biomedical tissues, etc., which we have covered the types later in this article. Advanced glaucoma surgery is a fast-growing field in glaucoma care. It is essential to be up to date with the latest techniques and trends. At eye solutions, we perform the most advanced techniques in glaucoma surgery.

Who needs Advanced Glaucoma Surgery?

Glaucoma tube shunt surgery is necessary when one has uncontrolled glaucoma despite medicines or trabeculectomy. You will need this type of advanced glaucoma surgery if the eye pressures are high because of or despite:

  • Your eyes have gone through many surgeries.
  • Failed trabeculectomy
  • Severe inflammation of the eye, which does not heal with medications.
  • You have suffered from a blunt injury to the eye.
  • Even though we perform this surgery as a last resort in the management of glaucoma, it has a better success rate. It is the last resort because post-operative care and management are lengthy and can be tedious for the patient.

What are the types of Glaucoma Tube Shunt Surgery?

There are three types of advanced glaucoma surgery:

  • Tubes: In this procedure, a tube goes into the eye. This tube is connected to a plate that is outside the eye. The tube drains fluid from inside to the plate outside and thus equalizes pressure in the eye. There are many tubes in the market. Some of the older ones caused many problems like over drainage of fluid from the eye, making the pressure very low. At Eye solutions, we use the most advanced tube with an internal valve. This valve prevents over filtration and maintains a normal pressure at all times. This tube is the Ahmed glaucoma valve. 
  • Stents: Stents are tiny microscopic devices inserted in the eye's drainage channel. They help drain fluid out of the eye by bypassing the normal drainage channels. Unlike tubes, there is no connection between the inside and outside the eye. This method is more prevalent in the west as it is very costly. Often, a single stent is not enough, in which case many stents get used. Read here to understand how stents work.
  • Biomedical tissue: also known as the Xen Gel Implant, a tube made of collagen that is 6 mm long and injected inside the eye. The other end of the tube comes out of the eye and helps equalize pressure. This technique is still in the research phase in India. Learn more about Xen Gel Implant.

Amongst all the techniques mentioned, the Ahmed glaucoma valve surgery is the safest and most successful in managing the condition.

What care should one Take after Glaucoma Tube Shunt Surgery?

  • Strict cleanliness, no touching the eyes
  • Water should not enter the eyes
  • Use sterile cotton to clean the eyes.
  • Not applying pressure to the eyes, which can make the eye pressure very low, affecting the other structures in the eye.
  • Using medications as advised by the doctor

What to expect after Glaucoma Tube Shunt Surgery?

  • Between day one and day 7 :

Eye pain and irritation due to sutures placed in the eye and the eye adjusting to the plate, which is placed on the eye. With medication, these symptoms are well-taken care of.

Low eye pressure: Called the hypotonic phase. It is very common to have eye pressure fall in the first seven days before it normalizes.

  • Between day seven and day 60:

High eye pressure: Called the hypertonic phase. It gets managed with eye drops till the pressure equalizes on its own. In some cases, eye drops for an extended period are necessary.
Mild irritation: this is due to the sutures which are absorbing.

What is the cost of this Advanced Glaucoma Surgery?

Coming back to the question about advanced glaucoma surgery cost in Mumbai. As mentioned earlier here, we place a specific device on the eye to help in reducing the pressure. Post-surgery care involves many visits to the eye doctor.

At Eye Solutions, we have tried to create packages where our patients don't have to keep paying us every time they visit the hospital. They pay us one fee and don't pay us for up to two months after surgery for all the post-surgery visits. Depending on the device used, our packages are from Rs 50000-80000, which includes the cost of the valve. Please feel free to contact us for further details.

Frequesntly Asked Questions ?

What does Glaucoma drainage valve implantation surgery do ?
It equalizes the pressure between the inside and outside of the eye via the tube that drains fluid from the inside to the reservoir outside so the pressure of the eye becomes normal.
Will this advanced Glaucoma Surgery restore vision ?
This surgery is to make sure that the part of the optic nerve that has not got damaged by the raised pressure doesnt get damaged further. It is a surgery that preserves vision rather than improves it.

Unfortunately the part that has already damaged is permanent as nerves once damaged can not revive.
When do we need to do a Glaucoma Tube Shunt Surgery ?
This surgery is advisable when all modes of treatment like medications, filtration surgery and laser treatment have failed. Once your glaucoma specialist advises you to undergo this surgery the sooner the surgery done the sooner there is a possibility of the pressure getting under control.
What care should be taken after the surgery ?
Strict cleanliness, no touching the eyes, water should not enter the eyes and only using sterile cotton to clean the eyes.

No applying pressure to the eyes as this can bring the eyes pressure very low which will affect the other structures in the eye

Using medications as advised by the doctor
What to expect after the surgery ?
Post surgery it is important that the patient comes for follow up every 2 days for the 1 st week as this is the crucial period during which the connection made in the eye heals.

The doctor will check if the pressure inside the eye is not too high or not too low and accordingly alter the managment post op.

Sometimes an injection in the eye is necessary post op to keep the connection open if the doctor feels it is getting blocked due to the healing process.

Patient will feel mild irritation due to sutures in the eye but that is only temporary.
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