Question 1

What are aqueous shunts and what do they do?

Accepted Answer

Aqueous shunts are microsurgical drainage devices that help control eye pressure in glaucoma by creating a new drainage channel. Reducing pressure on the optic nerve prevents further damage and further loss of vision. However, control of eye pressure with a shunt will not restore vision that has already been lost.

Question 2

How long will surgery take?

Accepted Answer

The operation is usually carried out under general anaesthetic. You can also have a local anaesthetic, in which case you will be awake but will not be able to see what is happening. You will be aware of a bright light and will be asked to keep your head still and lie as flat as possible. The operation normally takes about an hour. A member of the team is usually available to hold your hand if you wish. At the end, a pad or shield may be placed over the eye to protect it.

Question 3

What are the benefits of glaucoma tube surgery?

Accepted Answer

The most obvious benefit is lowering pressure inside the eye, helping control pain and ultimately prolonging useful vision. Your vision will not improve and may be temporarily worse as the pressure stabilises. The benefit is long term (years), rather than immediate.

Question 4

What are the risks of tube surgery?

Accepted Answer

As with all surgery, there is a small risk of complications either during or after the operation. In most cases complications can be treated, and in a small proportion of cases further surgery may be needed. Very rarely some complications can result in loss of sight. Specific risks include low eye pressure, bleeding inside the eye (suprachoroidal haemorrhage), cataract formation, double vision, infection, corneal clouding if the tube rubs the cornea, droopy eyelid, and the tube becoming exposed or blocked. If your eye becomes painful, red or blurred, seek immediate medical help.

Question 5

What happens after surgery?

Accepted Answer

The eye is normally padded after surgery and the pad is removed the following day. You may experience discomfort, itching, sticky eyelids and mild irritation. Paracetamol can be taken every 4-6 hours, but avoid aspirin as it can cause bleeding. You will be given eye drops to reduce pressure, inflammation and infection. Anti-inflammatory drops such as dexamethasone may be used very frequently at first; antibiotic drops are usually used four times a day. You should not rub your eye.

Question 6

When can I go back to work or school?

Accepted Answer

The time off work or school depends on your job, the vision in your other eye and the pressure in the operated eye. Someone working in an office environment would typically need about two weeks off if the post-operative course is smooth. Those whose work involves heavy manual labour or a dusty environment may need a month or more. This can be discussed with your consultant.

Question 7

What can I do after surgery?

Accepted Answer

It is important to avoid strenuous activity during the early post-operative period, including swimming, tennis, jogging and contact sports. It is fine to watch television and read. Avoid head-down positions such as bending to the floor or yoga inversions for the first two to three weeks, as these can cause pain when the eye is still inflamed. If your eye pressure is very low, your doctor may advise you to remain sedentary until it is restored. Always check with your doctor before resuming strenuous activity.

How long will surgery take?

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