Virtual Library | Glaucoma Surgical Treatments
If your pet has been diagnosed with glaucoma, diligent ongoing monitoring and treatment will be involved to maintain your loved one’s vision over time. There are several medical therapies and surgical treatment options, which will depend on the severity of the glaucoma, your pet’s age, whether other ocular problems are present, and the presence or lack of vision. Read on to learn about the vision-sparing surgical treatments available and the financial benefits of joining our Glaucoma Club.
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Your pet has been diagnosed with glaucoma, which will involve diligent ongoing monitoring and treatment to maintain your loved one’s vision over time. Initial medical therapy for glaucoma calls for intensive use of topical and oral therapy to help control the pressure in the eye. This can be highly effective in the early stages, but generally becomes less productive as the disease progresses.
For long-term control of glaucoma, surgical management is the best approach. There are several options, which will depend on the severity of the glaucoma, your pet’s age, whether other ocular problems are present, and the presence or lack of vision. Surgical procedures are primarily intended to either increase the flow of fluid out of the eye (shunt procedures) or reduce the amount of fluid production within the eye (laser procedures).
These vision-sparing surgical procedures are outlined on the following pages. And remember, you are not alone. Our Animal Vision Center of Virginia team is dedicated to help you find the best treatment solution for your pet and will be here with you every step of the way.
Trans-scleral Micropulse Laser Cyclophotocoagulation (CPC) is a newer, minimally-invasive glaucoma surgery that is applied indirectly to the ciliary body region through the sclera, using quick, repetitive laser pulses to minimize damage within the eye. This unique application of laser energy both mildly reduces fluid production as well as improves flow of fluid from the eye. This procedure is typically recommended on a preventative basis, or early in the course of glaucoma, when the pressure is elevating over time or at the high end normal (but before a major spike in pressure and damage to the optic nerve has occurred). It helps to delay/prevent the onset of severe glaucoma, and generally results in a 20-30% reduction in eye pressure and a decreased reliance on medical therapy without a significant risk for secondary complications.
Trans-scleral Laser Cyclophotocoagulation (CPC) is a more concentrated application of laser energy applied indirectly to the ciliary body through the sclera. This procedure causes direct damage to the tissue of the ciliary body region of the eye (where fluid is produced), resulting in a greater reduction of pressure within the eye, generally 50-60%. While clinically more effective, this higher power application of laser energy comes with an increased risk for secondary complications, such as pressure spikes during the post-op period; inflammation within the eye; corneal ulceration; cataract formation; retinal detachment; and persistent high or low pressure within the eye. It is typically recommended for cases of severe, acute, congestive glaucoma. Studies on trans-scleral CPC show 65-92% adequate control of pressure and 50-53% preservation of sight one year post-treatment.
Endolaser Cyclophotocoagulation (CPC) uses a fiber optic probe (endoscope) that is inserted into the eye to directly visualize and selectively target the individual ciliary processes within the eye. This direct application of laser energy allows for lower energy levels to be used and helps to minimize secondary complications by sparing the sclera and adjacent tissues from unnecessary damage. Studies on endolaser CPC have revealed 91% adequate control of pressure and 70% preservation of sight at one year following treatment, and 50-60% preservation of sight at two- to three-years post-op.
Gonioimplantation / Shunt Placement is another option occasionally recommended. This procedure involves inserting a small tube into the front chamber of the eye, which is connected to a valved base inserted under the conjunctival tissue surrounding the eye. This creates an alternate drainage pathway for fluid to leave the eye. While very effective in the short-term, after a few weeks’ time, the tube can become clogged with inflammatory debris or develop scar tissue around the base. This limits both ongoing fluid flow and long-term effectiveness. Shunts are generally used in association with a laser procedure on more severe glaucoma cases, but not typically as a sole surgical approach. The mainstay for long-term control of ocular pressure in veterinary patients is laser therapy.
Please note, when maintaining sight is not possible, it is generally more cost-effective to pursue an end-stage procedure to control the pressure in the eye.
Join Our Glaucoma Club
For $50 a month, members will receive a wide range of benefits that include:
- 20% off all services (including surgery)
- Free monthly pressure check/medication evaluation ($23 monthly value)
- 50% off quarterly examination and full-day pressure curve ($57.50 quarterly value)
- Same day pressure check/emergency appointment with any concern for pressure spike
- After-hour emergency Telehealth consultations (evaluation of ocular photos when you can’t come to our practice)
Our team is committed to keeping your pet visual and comfortable, and we hope the benefits featured here will help to alleviate some financial burden you may face.
If you’re interested in joining the Glaucoma Club, please call us at 757-749-4838 to learn more and get started.
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