A trabeculectomy is a medical procedure that can relieve pressure in the eyes, which is associated with glaucoma. It involves making a small hole in the eye that allows excess fluid to drain, decreasing pressure.
Glaucoma is a condition affecting the optic nerve. It is progressive and can lead to permanent vision loss. Treatments often focus on reducing pressure within the eye.
A trabeculectomy is a procedure that can help reduce pressure by increasing the amount of fluid that can leave the eye.
This article will review what a trabeculectomy is, how it differs from a trabeculotomy, the preparation required for the procedure, and more.
During the procedure, a surgeon makes a small hole in the eye wall, known as an ostium. They then place flap over it to allow a controlled release of aqueous fluid from the eye.
This allows fluid to drain out of the eye and into a small blister, known as a bleb, under the eye’s surface. The flap acts as a trap door, which enables fluid to pass through, bypassing the typical drainage channel and reducing IOP.
Doctors may recommend a person undergo a trabeculectomy if they do not respond well to other medications and treatments. Without treatment, the pressure in the eye may lead to further damage and vision loss.
A trabeculotomy is a similar procedure to a trabeculectomy. They both:
- take place in a medical facility
- require minimal recovery time
- help reduce IOP
- involve creating a small opening in the eye
The main difference between the two is that a trabeculotomy involves identifying the drainage system in the eye and inserting an instrument to open this canal and allow fluid to drain better. A surgeon will then use stitches to close the opening that enabled access to the drainage system.
Surgeons primarily use trabeculotomy for children and in cases of adult exfoliation glaucoma and steroid glaucoma in their early stages.
An eye doctor will likely recommend a person have an eye exam before the procedure to check visual acuity and several factors that may impact the surgery.
They may also order additional testing, review the person’s medical history, and perform a general physical examination. These steps can help determine what modifications a person may need to make before the procedure.
The doctor performing the procedure will provide instructions for what to do in the days or hours leading up to surgery. This may include medications to stop taking and when to stop eating or drinking, if applicable, as well as specific instructions, such as when to arrive for the procedure.
A trabeculectomy is an outpatient procedure. It typically takes up to 1 hour, though a person will need to allow additional time for prep and recovery.
Before the procedure, an anesthesiologist will provide local anesthesia to the eye or use general anesthesia. They will then use a device to help hold the eye open and expose the surgical site.
The surgeon will make the incision and create a flap for fluids to drain. A blister, or bleb, will form underneath the upper eyelid. After surgery, this is not typically visible when looking at the person.
A surgeon will then remove any devices used to open the eye. The person will spend some time in a recovery room to ensure they are feeling well.
Typically, people can go home on the same day. However, full recovery can take 4–6 weeks. During this time, a person will need to follow up with the surgeon as instructed and follow post-operation advice for care and recovery.
A trabeculectomy can help reduce pressure in the eye associated with glaucoma. It has around a 60–80% success rate at controlling pressure for 5 years.
Doctors may inject medication during or after the procedure to help prevent scar tissue from forming. However, the flap or bleb will scar over in some cases. If this occurs, a doctor may need to perform an in-office procedure called a bleb revision to break up the scar tissue.
Medications to help prevent scarring can increase the chance of eye infections, leading to:
It is best for a person to contact the surgical office immediately if they notice the above signs. This helps decrease the risk of losing vision as a result of infection.
The procedure can also increase the rate of cataract formation. At a later stage, people may need surgery to address cataracts.
A trabeculectomy is a surgical procedure to help reduce pressure within the eye that occurs due to glaucoma.
It involves creating a small opening that allows excess fluid in the eye to drain. The procedure is often successful at reducing the amount of pressure in the eye and preventing further damage from glaucoma.
It is typically an outpatient procedure that requires several weeks for a full recovery. During this time, a person will need to follow instructions from their surgeon to help prevent scarring and infection from developing.