Surgery may be the last resort in most cases of glaucoma if medication & laser are unable to control the disease. In congenital glaucoma, surgery may be the first option. 

Surgery is usually performed under local anaesthesia. General anaesthesia may be required in infants and young children. 

Trabeculectomy is the most commonly performed surgery in glaucoma. During this procedure a small partial thickness portion of the sclera (white part) of the eye is removed along with the small peripheral portion of the iris. 

In this procedure the new opening so created allows the intraocular liquid to bypass the clogged drainage canals. After surgery, the area over the site of surgery looks like a blister or bubble – called a bleb. 

Glaucoma microsurgery is usually successful, but occasionally the new drainage canal may begin to close and the pressure may rise again. This can happen because of the body’s natural tendency to heal the new opening in the eye. This is more common in younger patients who have strong healing capabilities compared to older people.

To retard such a healing, your doctor may use drugs like 5-Flourouracil (5-FU) or Mitomycin (MMC). These drugs may be used at the time of surgery or during the postoperative period in the form of injections around the eye. On occasion, eye drops may be needed inspite of surgery to control the intraocular pressure. Rarely one may have to reoperate if the opening created has totally closed.