With a pressure that high you should be on a variety of medications: something like travaprost, generic co-sopt, the new Vyzultra, if you can take it a beta blocker. What meds are you on?
Now for the second part of your question a laser trabeculoplasty will not lower the pressure 19-20 points but it is much less risky and much less expensive than a gel stent. PLEASE LIST WHAT EYE DROPS YOU ARE ON AND WHICH ONES YOU HAVE TRIED THAT DIDN'T WORK.
Also the decision to do laser first or gel stent depends on how much damage there is to your eye. If you have severe glaucoma and lost of damage to your optic nerve, bad looking visual fields and bad nerve fiber layer OCT than going to the stent would be appropriate.