A plain-language comparison of trabeculectomy, Ahmed valve implants and MIGS in Turkey, and how surgeons decide which one fits your eye.
20.10.2026
Patients often ask which glaucoma surgery is "the best", expecting a ranking like the one for laser eye procedures. In reality, surgeons choose between three families of operation, and the right one depends on how advanced the damage is, what has already been tried and how your eye heals. At our partner ophthalmology hospitals in Turkey, a trabeculectomy starts from €5,000 and an Ahmed valve implant from €5,200, and the choice between them is made after pressure readings and visual field tests, not before. Here is how the options differ in plain language.
All of them lower eye pressure by giving fluid a new way out of the eye, or by reducing how much fluid the eye makes. None of them restores vision that has already been lost; the goal is to protect the optic nerve fibres you still have. That is why the operation is only half of the treatment, and why the follow-up schedule matters as much as the technique. Our glaucoma surgery recovery guide explains what those first weeks involve.
In a trabeculectomy the surgeon creates a tiny flap in the white of the eye so fluid can drain into a small reservoir, called a bleb, under the upper eyelid. It is usually the first full surgical option tried, it can reach low target pressures, and it does not leave an implant behind. The trade-off is that it needs careful tuning in the weeks afterwards, because the body can scar the new channel shut. It tends to suit eyes that have not had much previous surgery and where a low target pressure is needed.
A drainage valve is a small device placed on the surface of the eye with a thin tube that carries fluid to a plate resting beneath the tissue. The valve regulates flow more predictably than a flap does, so surgeons often choose it when a previous trabeculectomy has failed, when scarring would make a flap unlikely to stay open, or in certain types of secondary glaucoma. It usually involves a period of higher pressure while the device settles, followed by a drop, and some patients still need a drop or two afterwards.
Minimally invasive glaucoma surgery uses very small implants or incisions, often combined with cataract surgery. Recovery is faster and the risk profile is lower, but the pressure reduction is more modest. MIGS is aimed at mild to moderate glaucoma where the goal is fewer drops rather than the lowest possible pressure. If your visual field loss is already advanced, your surgeon is likely to recommend a filtering operation or a valve instead, and that is a clinical decision rather than a sales one.
The surgeon weighs your current pressure and target pressure, the stage of visual field loss, previous laser or surgery, whether you have had cataract surgery, and the type of glaucoma. To get a recommendation and a quote before you travel, send your recent pressure readings, visual field reports and a list of current drops. Plan on a longer stay than for most eye surgery, usually ten to fourteen nights for a filtering operation, because the early follow-up visits are part of the treatment itself.
Contact your coordinator or the clinic straight away if pain increases sharply instead of settling, vision drops suddenly after being stable, the eye becomes very red with thick discharge, you notice a shower of new floaters or a dark curtain at the edge of your vision, or clear fluid leaks from the operation site. Pressure that is too low causes problems just as pressure that is too high does, so unexplained deep aching or worsening blur is worth a call. These complications are uncommon, but eyes do not tolerate delay.
Is MIGS better because it is less invasive?
Not automatically. It is gentler and heals faster, but it lowers pressure less, so it suits earlier disease. Advanced glaucoma usually needs a trabeculectomy or valve.
Can a valve be placed if a trabeculectomy already failed?
Yes. A valve is often the next step in that situation, and your surgeon will plan it as part of your long-term pressure strategy rather than as a rescue.
Will I still need drops after surgery?
Often fewer, sometimes none, but some patients still need drops for full control. This is monitored at follow-up visits rather than decided on the day of surgery.
This page is general information, not medical advice. Suitability, technique and results are determined individually by a licensed doctor.
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