Glaucoma Surgery

With Wyoming’s premier glaucoma specialist

No two patients are the same—the way no two pairs of eyes are the same—which means we work with you to personalize your treatment plan. The Cheyenne Eye Clinic & Surgery Center has all of the most modern and advanced equipment to provide patients early and accurate diagnosis, as well as multiple options for treatment.

LASER TREATMENTS: Dr. Miller performs Selective Laser Trabeculoplasty (SLT). This is an outpatient procedure that only takes a few minutes to perform and is typically painless. The laser light is focused into the drainage canals and stimulates special cells (macrophages) to clear out debris, allowing the fluid of the eye to exit more easily. About 75–80% of patients experience pressure reduction, eliminating the need to take eye drops for some time. The effect of the laser will wear off over time, but can be safely repeated. Most patients enjoy at least 2 years and often more, of pressure reduction from SLT.

Another laser procedure, laser cyclodiode, is performed in the operating room when other treatment options have not allowed sufficient eye pressure lowering or the patient is not a good candidate for them.

GLAUCOMA AND CATARACT SURGERY: If a patient with glaucoma has cataract surgery, this is an excellent opportunity to allow further reduction of the eye pressure by implantation of an iStent™. The iStent is a type of MIGS procedure (minimally invasive glaucoma surgery). Dr. Anne Miller has performed this delicate procedure on over 100 happy patients, many of whom enjoy taking fewer (if any) glaucoma drops afterward!

SURGICAL TREATMENT: Once other options have been exhausted, surgery can be an excellent way to achieve even lower eye pressure and temporarily eliminate the need for eye drops. Dr. Miller performs ExPRESS mini shunt glaucoma drainage device procedures in many patients. This surgery reroutes the fluid of the eye onto the surface (under the upper eyelid) where there is less resistance to outflow and the fluid is absorbed. Several follow up visits after the surgery are necessary to ensure a good result.

If the ExPRESS surgery scars too much, and / or the patient is not an appropriate candidate, often a tube-shunt procedure is the next step. Dr. Miller uses Ahmed and Baerveldt glaucoma drainage devices.