Glaucoma: the best treatments available today

Written by: Mr Saab Bhermi
Published: | Updated: 24/04/2023
Edited by: Top Doctors®

Leading consultant ophthalmologist Mr Gurpreet Saab Bhermi takes us through the treatment options available for glaucoma.

Glaucoma drainage surgery

Using powerful anti-scarring agents and releasable stitches, glaucoma drainage surgery is a proven method to give you optimal results. The procedure can be performed under local anaesthetic so you are able to go home on the same day.


Xen® implant

A Xen® implant is a 6mm microtube, inserted with no cuts or stitches in the conjunctiva and performed with just drops in under 5 minutes. This microtube is so small and effective it has revolutionised glaucoma surgery allowing us to simplify the procedure and still have the benefits of safe, long lasting drainage.



Trabeculectomy entails forming a small channel through the white part of the eye. This channel will allow fluid - made naturally in the eye - to drain away. Some patients will require a special medication (Mitomycin C) to be placed around the incision site to try to ensure that the hole does not scar over. The drainage site is under the upper eyelid and will not be seen, and once settled should not cause you discomfort. The fluid will drain from the channel and be absorbed by conjunctival vessels in the skin of the eye.



Canaloplasty is a new procedure which uses safer, non-penetrating techniques to open up the drainage canal without ever entering the eye. These new techniques allow safe and effective surgical treatment for high eye pressure.



The iStent® is a new drainage device which safely lowers pressure the natural way without having to cut into the skin (conjunctiva), so reducing the risk of scarring or failure. It is a quick and effective way of lowering pressure, with less trauma to the eye than conventional surgery.


Laser and eye drop treatments:

Glaucoma laser treatment has become increasingly common and can in many cases mean the patient can resume normal activities in a short amount of time. There are various types of laser surgery options most of which will still be combined with medication of some kind. This combined approach should help to reduce intraocular eye pressure and maintain it too. Having any surgery can be daunting but glaucoma laser surgery is usually a faster and more effective treatment with little interference to daily life once complete. Sometimes it might be necessary to repeat a procedure but individual outcomes and next steps can be discussed with an ophthalmologist.


Micropulse diode and selective laser

This is a new and repeatable glaucoma treatment without scarring, that painlessly lowers pressure and allows many patients to do away with their daily eye drops. Micropulse technology utilises the most advanced laser energy, to deliver highly accurate and precise treatment, without unwanted side effects. This allows a consultant ophthalmologist to deliver new treatments which were not possible, or as effective, with previous argon type lasers.




If you require further information about the best glaucoma treatment for you, and how it can be implemented, arrange a consultation with Mr Bhermi via his Top Doctors profile

By Mr Saab Bhermi

Mr Saab Bhermi is a leading senior consultant working in the cataract and glaucoma services at the world-renowned Moorfields Eye Hospital. He is an expert in bespoke cataract surgery with a particular focus on premium intraocular lens implants (multifocal, extended depth of focus and astigmatism-correcting toric implants).
For glaucoma he offers the full range of available treatments including laser, surgery and non-surgical options. Surgical treatments include traditional trabeculectomy and the more modern Minimally Invasive Glaucoma Surgeries (MIGS), PreserFlo, Paul and Baerveldt implants.
His expertise in both cataract and glaucoma treatment is particularly beneficial, as these conditions often coexist in patients, and allows for a combined treatment approach tailored to each individual's unique needs
Mr Bhermi graduated from Dundee University Medical School in 1990 and underwent extensive post-graduate training at leading London Teaching Hospitals. He also undertook three additional Fellowships – a Research Fellowship investigating techniques to prevent complications of cataract surgery (St. Thomas’ Hospital), and Clinical Fellowships at Moorfields (Cataract Surgery) and The Western Eye Hospital (Glaucoma).
He is extremely experienced with over 30yrs clinical experience. He has carried out over 20,000 successful surgical procedures with high patient satisfaction. He continues to teach clinical ophthalmology and surgery to junior doctors and upcoming consultants.

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