The proceedure that was described is to cut a trap door in the iris and close it with many tiny suchurs. To regulate the presure the physician can laser cut some of the suchurs to decrease the presure. From what I understand this takes some time and experimentation to acquire the lowered presure without softening the eye which would cause other problems. I have had two laser sugeries and have been on pills and drops for years. It would seem I am at the end of the treatment road and that this is a more radical proceedure since I have already lost vision in the nasal area of the right eye and it is now starting in the left. By the way I am 63 and discovered the condition at the age of 51. Thanks for your interest and your comments. I hope this is helpful to all.
This sounds like a trabeculectomy, which is the most common surgical procedure done for most types of glaucoma. It is very effective, but can have some annoying side effects early on. What you've been told is exactly right, and important to understand.
What follows is very general advice....
The surgery itself is a little longer and more complicated than a cataract extraction or some other simpler surgeries. It's common for the eye to be a little more sore and/or scratchy than after a cataract procedure.
Your vision will most likely be worse than your baseline in the early postoperative period and may fluctuate. It may be much worse. This is partly because of increased outflow of fluid from the eye, which can change the shape of the eye and change its focus. Generally your become more nearsighted temporarily. As the outflow stabilizes, the eye will return to its baseline, but that can be very quick or take even a few weeks (rarely)
The purpose of the surgery is to create a controlled "leak" from the eye into the compartment between the white of the eye and the clear membrane which covers it. You will have several visits close together to check the pressure, and may have some sutures cut with a laser if the pressure is too high. The idea is to make a trap door bigger than you need, and then sew it partly back, so that it's probably smaller than you need. Postop, the sutures are visible through a clear membrane, so you can shoot them with a laser to open the trap door up a bit, without having to go back in and redo the surgery. This way you can adjust the outcome over the few days or weeks after surgery.
You'll be on new drops for probably a month, but there's a good chance that after you heal you will no longer need your glaucoma drops, or may need fewer that you had preop.
There will be a small blister (called a "bleb") that forms under your upper eyelid where the fluid that leaves the eye collects. This is normal, but patients are often scared by it if they discover it accidentally when they lift their lid in the mirror.
I have patients who have been flying for many years with glaucoma, including some who maintain first class medicals.
If you are continuing to progress (your visual fields are worsening or you nerve is getting worse) in spite of maximum tolerated medical therapy, then surgery is the right choice.
