Glaucoma Surgery: When Eye Drops Are Not Enough
A Seoul ophthalmologist’s guide to surgical options for glaucoma — glaucoma surgery Seoul patients can trust
Q. When is glaucoma surgery necessary?
Glaucoma surgery becomes necessary when eye drops and laser treatment no longer keep intraocular pressure (IOP) low enough to protect the optic nerve from further damage. For patients in Seoul managing progressive glaucoma, options range from minimally invasive glaucoma surgery (MIGS) to traditional filtering procedures like trabeculectomy, chosen based on glaucoma type, severity, and how much drop therapy has already been tried.
Q. What is glaucoma surgery?
Glaucoma surgery refers to a group of procedures designed to lower intraocular pressure by improving the eye’s natural drainage of aqueous humor or by creating a new drainage pathway. Unlike eye drops, which need to be applied daily and depend on patient adherence, surgery offers a more consistent, long-term reduction in eye pressure. At Nunehim Eye Center in Yeongdeungpo-gu, Seoul, we typically recommend surgery only after drop therapy and, in many cases, laser treatment such as selective laser trabeculoplasty (SLT) have been tried and have not achieved target pressure.
Q. What are the signs eye drops aren’t working?
- Intraocular pressure remains above target despite maximum tolerated drop therapy
- Visual field tests show continued narrowing or new blind spots
- OCT imaging reveals progressive thinning of the retinal nerve fiber layer
- Poor adherence to multiple daily drop regimens due to side effects or lifestyle
- Optic nerve cupping continues to worsen on serial exams
Glaucoma in Korea: Key Statistics
▸ Glaucoma affects an estimated 4% of Koreans over age 40, and prevalence rises sharply after 60
▸ Normal-tension glaucoma — common in Korean populations — accounts for roughly 70% of open-angle glaucoma cases in Korea, higher than in Western countries
▸ Up to half of glaucoma patients in Korea remain undiagnosed until moderate optic nerve damage has occurred, according to national eye health surveys
▸ Regular checkups every 6-12 months are recommended for adults over 40 with a family history of glaucoma, especially in urban Seoul districts like Yeongdeungpo, Guro, and Gasan
Q. What are the surgical options for glaucoma surgery Seoul patients can choose from?
Minimally invasive glaucoma surgery (MIGS) has become the first surgical step for many patients with mild to moderate glaucoma. These procedures use microscopic devices or techniques — such as trabecular micro-bypass stents or goniotomy — to enhance the eye’s own drainage system through a small incision, often combined with cataract surgery. MIGS carries a lower risk profile than traditional surgery and typically allows faster recovery, making it attractive for working patients across Yeongdeungpo and Guro who cannot take extended time off.
For more advanced or uncontrolled glaucoma, traditional filtering surgery such as trabeculectomy or tube shunt (glaucoma drainage device) implantation may be recommended. Trabeculectomy creates a new drainage channel beneath the conjunctiva, allowing fluid to bypass the eye’s blocked natural outflow pathway. These procedures achieve larger pressure reductions than MIGS but require closer postoperative monitoring and carry a higher rate of complications such as hypotony or bleb-related infection.
Q. What happens during MIGS or trabeculectomy?
Most glaucoma surgeries at our Seoul clinic are performed under local anesthesia with sedation, and patients go home the same day. MIGS procedures generally take 15-30 minutes; trabeculectomy or tube shunt surgery may take 45-60 minutes. During trabeculectomy, a small flap is created in the sclera to allow controlled fluid outflow into a filtering bleb, and an anti-scarring agent (mitomycin-C) is often applied to keep the new drainage channel open. Patients typically return for pressure checks within 24-48 hours after surgery, then at regular intervals over the following weeks.
Q. What are the risks and recovery expectations?
- Temporary blurred vision and mild discomfort for several days to weeks
- Risk of low eye pressure (hypotony), bleeding, or infection, more common after trabeculectomy than MIGS
- Some patients still require one or more glaucoma medications after surgery, particularly with MIGS
- Full visual recovery can take 4-8 weeks; strenuous activity should be avoided during this period
- Regular follow-up visits are essential to monitor bleb function and intraocular pressure
Stages of Glaucoma
Mild: early nerve changes, normal vision. Moderate: visual field defects appear. Severe: significant vision loss risk.
Surgical Options
MIGS (stents, goniotomy) — Trabeculectomy — Tube shunt (drainage device)
Recovery Timeline
Week 1: pressure checks, rest. Weeks 2-4: gradual activity. Month 2+: long-term monitoring.
From Dr. Daniel Baik
“In my practice treating glaucoma patients across Yeongdeungpo, Guro, and Gasan, I’ve found that surgery is never a first step — it’s a decision we reach together once drops and laser therapy have been given a fair chance. When surgery is needed, MIGS lets many patients return to normal life within days, and even trabeculectomy, done at the right time, protects vision that would otherwise be lost.”
— Dr. Daniel Baik, board-certified ophthalmologist, Nunehim Eye Center
❓ Frequently Asked Questions
Q. Is glaucoma surgery painful?
Most patients experience only mild discomfort during and after surgery, as the eye is fully numbed with local anesthesia and sedation. Some pressure sensation or a gritty feeling is common in the first few days, managed with prescribed eye drops and, if needed, mild oral pain relief.
Q. How long does it take to recover from glaucoma surgery?
MIGS patients often resume light activities within a few days, while trabeculectomy or tube shunt patients typically need 4-8 weeks for the eye to stabilize fully, with several follow-up visits during that period.
Q. Will I still need eye drops after glaucoma surgery?
Many patients reduce or eliminate their glaucoma drops after trabeculectomy or tube shunt surgery, though some still need one medication for full pressure control. MIGS patients often need fewer drops than before, but complete elimination is less certain.
Q. Can glaucoma surgery restore vision I’ve already lost?
No. Glaucoma surgery lowers eye pressure to prevent further optic nerve damage, but it cannot reverse vision loss that has already occurred. This is why early detection and timely treatment are critical.
Q. How do I know if I need MIGS or trabeculectomy?
The choice depends on your glaucoma type, severity, target pressure, and whether you’re also having cataract surgery. During your consultation at Nunehim Eye Center, we review your visual field results, OCT scans, and pressure history to recommend the most appropriate procedure.
Q. Is glaucoma surgery covered by national health insurance in Korea?
Most medically necessary glaucoma surgeries, including trabeculectomy and many MIGS procedures, are covered under Korea’s National Health Insurance when performed for diagnosed glaucoma. Coverage details can vary, so we recommend confirming your specific case during consultation.
Q. How often should I have my eyes checked after glaucoma surgery?
Initially, follow-up visits occur within 24-48 hours, then weekly for the first month, tapering to every few months once intraocular pressure stabilizes. Long-term, annual visual field and OCT monitoring continues indefinitely to watch for disease progression.
Book a Consultation
Nunehim Eye Center — nunehim.com — Yeongdeungpo-gu, Seoul
📍 Visit Nunehim Eye Center — Guro, Seoul
Convenient access from Guro, Gasan, Gwanak & Dongjak. Near Guro Digital Complex Station (Line 2).
Address: 551 Siheung-daero, Guro-gu, Seoul · nunehim.com
Hours: Mon–Fri 09:00–18:30 (lunch 13–14), Sat 09:00–14:00
Languages: Korean & English
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