Glaucoma Surgery in Delhi

Glaucoma surgery creates a new drainage pathway for aqueous humour, lowering intraocular pressure and preventing further optic nerve damage. The two main types performed at Netram are trabeculectomy (gold standard) and Ahmed Glaucoma Valve implantation (for complex cases). Both are well-established, widely performed procedures. Trabeculectomy has a 50+ year track record. Serious complications (endophthalmitis, vision loss) occur in less than 1% of cases at experienced centres.

No — this is one of the most important things to understand about glaucoma surgery. Vision already lost to glaucoma is permanent and cannot be recovered. The optic nerve fibres destroyed by elevated IOP do not regenerate. The purpose of glaucoma surgery is to stop or slow further vision loss — protecting the vision that remains. This is why early diagnosis and timely surgery are so critical.

Trabeculectomy is an incisional filtration surgery that creates a new drainage opening through the sclera, allowing aqueous to drain into a subconjunctival bleb. It is the gold standard for primary glaucoma. The Ahmed Glaucoma Valve is a drainage implant — a silicone tube connected to an external plate that drains aqueous into a posterior bleb. It is preferred for complex, secondary, or refractory glaucoma where trabeculectomy is high-risk or likely to fail. Trabeculectomy generally achieves lower IOP; the Ahmed valve carries lower risk of early hypotony due to its built-in pressure-sensitive valve.

Trabeculectomy with MMC has a 70–80% complete success rate at 5 years — meaning IOP controlled without any drops. Qualified success (IOP controlled with fewer drops than before) exceeds 90%. Some blebs fail over years due to progressive scarring — revision surgery or additional procedures may be needed. The Ahmed Glaucoma Valve has a similar long-term profile in complex glaucoma cases. Regular monitoring is essential regardless of the procedure.

Many patients achieve IOP control without any drops after successful trabeculectomy. However, some patients require one or two drops to supplement surgical IOP control — particularly as the bleb matures and possibly scars over the years. Ahmed Valve patients are more likely to need supplemental drops at some stage. The goal is to reduce drop burden significantly, protect the optic nerve, and preserve vision — not necessarily to eliminate drops entirely.

Trabeculectomy with MMC is priced at ₹25,000 per eye. Ahmed Glaucoma Valve implantation is ₹25,000 per eye plus the cost of the AGV device (consult our team for total package). Combined phaco-trabeculectomy is ₹25,000 for the trabeculectomy component plus the phaco/IOL cost depending on your lens choice. Glaucoma surgery is covered under most insurance policies — our team assists with cashless claim processing. EMI options are also available.

You go home the same day in most cases, with an eye shield and antibiotic-steroid drops. The most critical period is the first 2 weeks — your surgeon will review you on Day 1, then at Day 3–7 for bleb assessment and suture adjustment, then weekly for the first month. The bleb (or the Ahmed plate bleb) matures over 4–8 weeks. Vision may be blurry during this period — this is expected and resolves as healing progresses.

The filtering bleb is the elevated area of conjunctiva that forms over the sclerostomy — it is the site through which aqueous drains. Bleb morphology determines long-term IOP control. In the first 2–4 weeks, the surgeon manages the bleb by releasing releasable sutures, performing laser suture lysis, giving 5-FU injections, or applying digital pressure — all to optimise bleb height, size, and function. This active post-operative management is what separates expert trabeculectomy care from average — and it is why the first month of follow-up is intensive and non-negotiable.

Yes — combined phaco-trabeculectomy is a well-established procedure performed at Netram. It is recommended when both cataracts are visually significant AND glaucoma requires surgical IOP control. The advantages are: one anaesthesia, one recovery, and cataract removal itself lowers IOP by deepening the anterior chamber. The IOP-lowering effect may be slightly less aggressive than standalone trabeculectomy in some cases — your surgeon will discuss whether combined or staged surgery is more appropriate for your specific situation.

Yes — glaucoma surgery (trabeculectomy and glaucoma drainage device implantation) is covered under most health insurance policies and government schemes in India including CGHS, ECHS, and most TPA-empanelled policies. At Netram, we are empanelled with major insurance providers and assist patients with pre-authorisation, cashless claims, and reimbursement documentation. Contact our front desk before your appointment to confirm coverage for your specific policy.