Glaucoma Laser & Surgery

We understand that living with glaucoma can be concerning, and we’re committed to providing the most advanced surgical treatments at Eastwood Eye Specialists.

Glaucoma is a common sight-threatening disease that damages your eye’s optic nerve, the neural “signal cable” that allows the visual information from the eye to be transmitted to the brain so that you can see. It results in progressive loss in your peripheral or side vision, and can eventually cause blindness. Higher pressure inside the eye (intraocular pressure or IOP) causes glaucoma, resulting in stress on the optic nerve and thus progressive loss of the nerve fibres. All current treatments for glaucoma (medicine, laser and surgery) are aimed at lowering this eye pressure in order to protect vision.

With a focus on preserving your vision and enhancing quality of life, we’ll guide you through every option: explaining risks, benefits, and recovery expectations, so you can make informed decisions about your eye care.

Procedure Mechanism Ideal Use Expected IOP Reduction
<a href="#slt">SLT (Selective Laser Trabeculoplasty)</a> Laser applied to trabecular meshwork to enhance outflow First-line or adjunctive therapy in open-angle glaucoma Mild to Moderate
<a href="#micropulse">Micropulse Laser</a> Laser pulses to reduce aqueous production without tissue damage Mild to moderate glaucoma or repeat laser Moderate
<a href="#cyclodiode">Cyclodiode Laser</a> Laser to ciliary body to reduce aqueous production Advanced or refractory glaucoma Moderate to High
<a href="#migs">MIGS (e.g. iStent, Kahook)</a> Minimally invasive procedure to improve outflow Mild to moderate glaucoma (often with cataract surgery) Mild to Moderate
<a href="#presser">PreserFlo MicroShunt</a> Implants a micro-shunt to drain aqueous to subconjunctival space Moderate to advanced glaucoma Moderate
<a href="#trab">Trabeculectomy</a> Creates a new scleral drainage pathway under the conjunctiva Advanced glaucoma needing low IOP High
<a href="#tube">Tube Shunts (Paul, Baerveldt)</a> Drains excess fluid via tube implant to lower pressure Refractory or failed previous surgery High

* IOP = intraocular pressure / eye pressure

 
Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) is a proven, safe and effective laser treatment for glaucoma and elevated eye pressure that can be comfortably provided in the clinic by our experienced eye specialists.

SLT utilizes the delivery of multiple ultra-fast, painless laser beams to help rejuvenate and enhance the drainage function of the natural outflow channels of the eye, and thereby reducing eye pressure. SLT has been proven to be an effective first-line treatment for glaucoma and can be used as an alternative to daily eye drops, thereby improving patient’s quality of life, no risk of missed or forgotten eye drops, and avoiding the numerous side effects associated with long-term medications.

 
Micro Invasive Glaucoma Surgery (MIGS)

MIGS encompasses a class of procedures performed through small incisions, often alongside cataract surgery, to enhance natural aqueous drainage.

These procedures carry a high safety profile, induce minimal anatomical disruption, and offer faster recovery compared with traditional glaucoma filtering surgeries.

Major MIGS examples:

  • Procedures like iStent, Hydrus microstent, GATT, TRAB360, OMNI, Kahook dual blade and the Streamline System represent varying approaches to enhancing drainage via trabecular trabeculotomy, canaloplasty, or tissue excision.
MIGS generally achieves a mild to moderate IOP reduction. However, it is not sufficient in advanced glaucoma where lower IOP targets are required.

 
PreserFlo MicroShunt

The PreserFlo MicroShunt is a biocompatible shunt inserted to divert aqueous fluid beneath the conjunctiva, forming a drainage reservoir that helps to lower eye pressure. It is non metallic (safe for MRI) and effectively lowers IOP in moderate to advanced glaucoma.

 
Trabeculectomy

This traditional “filtering” surgery involves creating a tiny flap in the sclera (white of the eye) to allow fluid to drain into a subconjunctival reservoir, lowering the eye pressure. Trabeculectomy offers substantial IOP lowering—often needed in advanced glaucoma.

 
Tube Shunt Implants (e.g. Paul, Baerveldt)

Tube drainage devices such as Baerveldt and Paul implants drain fluid into a reservoir under the conjunctiva to lower eye pressure. These are typically used in refractory or high-risk glaucoma cases or patients whose demographics preclude them from other options. This can be highly effective in lowering eye pressure.

Combined Cataract + MIGS Approaches

Many surgeons combine phacoemulsification (cataract surgery) with MIGS procedures such as iStent, Hydrus, or Kahook Dual Blade. This integrated approach can provide additional IOP lowering and reduce medication burden in mild to moderate glaucoma, with a favourable safety profile and quicker visual recovery

 
Micropulse Laser Therapy

Micropulse laser is a gentle, pulse laser treatment used to lower eye pressure in glaucoma. It works by delivering tiny bursts of laser energy to the eye's fluid-producing tissue, helping to reduce the amount of fluid made with minimal harming surrounding structures. It’s suitable for moderate to advanced glaucoma and has minimal recovery time, often with little discomfort or inflammation afterward.

 
Cyclodiode Laser Therapy

Cyclodiode is a stronger laser treatment that targets the part of the eye that produces fluid, helping to lower eye pressure. It’s typically used in more advanced or difficult-to-treat glaucoma. While effective, it may carry a slightly higher risk of temporary eye discomfort, inflammation, or low pressure, especially with stronger or repeated treatments.