Trabeculectomy

What is a trabeculectomy?

Trabeculectomy is a surgical procedure used to lower eye pressure in people with glaucoma. Glaucoma is an eye disease in which the optic nerve is damaged because of high pressure inside the eye. Lowering the eye pressure can stop the damage from continuing, although no treatment can restore the damage that is already done.

In this procedure, the surgeon creates a microscopic passageway from the inside to the outside of your eye. This helps fluid drain better from your eye. It can lower the pressure in your eye and help prevent more damage to the optic nerve and loss of vision.

Trabeculectomy may be used when:

• Medicines do not lower your eye pressure enough.
• You are having harmful side effects from medicines you are taking for the pressure in your eyes.
• Laser surgery to lower the eye pressure has not worked or is not possible.

What happens during the procedure?

The procedure is done in an operating room. You will be given a sedative to help you relax. You will be given a shot of a local anesthetic to make you comfortable during the surgery. General anesthesia is necessary for some people.

After you have been given the anesthetic, your doctor will move back the transparent tissue over the white part of the eye. Then he will carve a small channel so that fluid can flow from inside to the outside of the eye with less more easily. Your doctor may put some medicine on the eye to reduce scarring if necessary. He will close the eye with small stitches.

The surgery does not leave an open hole in your eye. The white of your eye is covered by a thin, clear tissue called the conjunctiva. The fluid flows through the new opening, under the conjunctiva, and drains from the eye.

What happens after the procedure?

You will need to be examined the next day. Your doctor may want to check your eyes once or twice a week for 4 to 6 weeks after your surgery.

You will use various eye medicines after surgery to help healing and to reduce the risk of infection.

Your vision may be blurred for several weeks after surgery. As your eye heals, your vision should improve and your eye pressure should be lower. You may need medicine after the surgery to help maintain normal eye pressure. Once your eye heals, you may need to get a new eyeglass prescription.

What are the risks?

All surgery carries some risks. After surgery you may:

• Develop a cataract (cloudy lens in the eye), which happens to about one-third of people in 5 years.
• Have scarring around the new drain.
• Have bleeding in your eye. Bleeding a lot is very rare. A little blood in your eye is common and usually does not need treatment.
• Develop an infection. This can happen long after the surgery. You should call your doctor immediately if you have pain, redness, or drainage in the eye that you have had glaucoma surgery.
• Have too much drainage. This is usually controlled successfully with minor treatment such as patching the eye shut for a day or two. However, sometimes further surgery is required.