What is Goniotomy?

A goniotomy is a surgery performed to relieve eye pressure for patients with moderate glaucoma. The procedure may be used alone or in combination with glaucoma medications or eye drops. Goniotomy creates an opening in the first layer of the eye’s natural drainage system known as the trabecular meshwork. This allows fluid to more easily flow away from the eye and works to lower pressure. If you have glaucoma or several risk factors for the disorder, this can be an important procedure.

Who is a Candidate for Goniotomy?

A goniotomy is performed to treat patients with glaucoma at the time of cataract surgery. In other cases, it may be used for patients who have:

  • Aniridia (no visible iris)
  • Uveitic glaucoma associated with juvenile rheumatoid arthritis
  • Juvenile open-angle glaucoma (JOAG)
  • Maternal rubella syndrome

If you are at a high risk for postoperative bleeding, this may not be the procedure for you.

How is Goniotomy Performed?

Goniotomy surgery is performed under sedation in an operating room. Topical anesthesia or numbing cream is also applied to the eyes before the procedure. After using instruments to ensure the eye remains open, incisions are made in the front of the eye. Specialized lenses are then placed on the eye to examine the natural drain of fluid. After removing a portion of the blockage from the drain, open channels are created to allow fluid to drain from the eye. During the procedure, you will see bright lights but will not feel pain. The surgery typically takes about five minutes. 

Recovery After Goniotomy 

Immediately after surgery, protective shields are placed over the treated eye(s). Patients will require a trusted family member or friend to drive them home due to sedative medications. After a goniotomy, most patients are also required to take antibiotics and other medications such as corticosteroids for about one to two weeks. Periodically after the procedure, your ophthalmologist will need to reevaluate the eye in a procedure that requires anesthesia.

Most patients do not experience a recurrence of glaucoma following goniotomy. Often, patients who undergo goniotomy no longer require other glaucoma treatments such as eyedrops or medication, though this varies.

Schedule an Appointment 

To learn more about glaucoma treatment, including a goniotomy, schedule an appointment with an ophthalmologist at Boston Vision. To schedule your appointment, book an appointment online or give us a call at 617-202-2020.

The Goniotomy procedure is available at all our locations: Brookline, Milford, Medford, Lawrence, Wellesley, Burlington, Woburn, and Andover.

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