What are surgical options for a VISUAL eye with primary glaucoma?

• A. Enucleation +/- Orbital Prosthesis
• B. Creation Of New Drain = Gonioimplant, Filtering Procedures; Decrease Production = Cyclocryosurgery Or Cyclophotocoagulation
• C. Laser Refractive Surgery
• D. Intravitreal Injections

Answer: (B)

In a visually useful eye with primary glaucoma, the surgical goal is to lower intraocular pressure to protect the optic nerve, using approaches that either enhance drainage or reduce aqueous production. Increasing outflow can be achieved with procedures that create a new drainage pathway, such as filtering surgeries (like trabeculectomy) or glaucoma drainage devices (gonioimplants/tube shunts) that divert aqueous humor to an external reservoir. Reducing production is done with cyclodestructive methods that target the ciliary body, including cyclocryosurgery or cyclophotocoagulation, which decrease how much fluid the eye produces.

Laser refractive surgery is not aimed at lowering IOP and doesn’t address glaucoma management, while intravitreal injections treat retinal conditions rather than glaucoma. Enucleation removes the eye and is not a standard glaucoma treatment for preserving vision. So the best option covers both main surgical strategies—creating a new drainage route and decreasing production—to lower IOP in a visually important eye.