Trabeculectomy

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Trabeculectomy

Trabeculectomy is a surgical procedure that is used for treating glaucoma.

Glaucoma is an illness that occurs when the fluid that your eye produces, known as aqueous humor, is unable to drain normally. This leads to the intraocular pressure (IOP) to increase over time, and this can eventually lead you to vision loss or blindness if you leave it untreated.

Trabeculectomy can help to lower the intraocular pressure inside your eye, which can help in slowing or stopping the vision loss that occurs due to glaucoma. This procedure helps to create a new channel through which fluid is able to drain from the eye. Restoring the ability of the eye to drain fluid results in the IOP getting lower.

Though this procedure is unable to cure any glaucoma-related vision loss that you experienced before the procedure, it can help to slow or stop progressive vision loss in the future.

Purpose

When treatment with pills, eye drops, or laser surgery fails to lower the intraocular pressure to a safe level, your eye doctor might recommend this surgery. Making a new drain in the eye helps to reduce pressure in an eye suffering from glaucoma.

Preparation

Before the surgery, make sure you inform your doctor about all your current medications, including blood thinners and eye drops. He/she will let you know whether to continue your regular routine until the day of your procedure, or whether you need to stop.

Your eye doctor will also be evaluating the affected eye and consider any pre-existing conditions in the eye that could be leading to complications during or after your procedure. Your doctor might also need to perform a general wellness check to address any possible underlying conditions before your surgery. This is done especially if you’ll be going under general anesthesia. It is also likely that your doctor will ask you to fast for at least 12 hours before the procedure.

Procedure

The procedure will be done in an operating room, under either general or local anesthesia. If you receive general anesthesia, you’ll be asleep throughout the procedure. If you receive local anesthesia, your eye is going to be numbed.

Your eye is then going to be fitted with a lid speculum for holding it open. You’ll be next covered in a drape that exposes nothing but your eye.

First, your surgeon will be opening a bleb at the top of your eye. Since this is done beneath the eyelid, it is not going to be visible after the procedure. Once your surgeon is able to create the new drainage site, your surgeon will place sutures near the sites meant for holding the flap over the bleb open. Your stitches are not going to dissolve and you need to visit your doctor again after around two weeks to get them removed.

The surgery should generally be done in around an hour. Once it is done, your eye is going to be patched and shielded till your follow-up appointment with your surgeon the next day.

After the procedure

It may take around 3 months after your surgery for your healing to be complete. During this time, your intraocular pressure, as well as your vision may fluctuate. You can change your glasses prescription at around 6-8 weeks after the surgery.

Results

The results of a trabeculectomy generally depend on various factors. Generally, 70 percent of operated eyes usually have satisfactory results and don’t require medications for at least a year after the procedure.

Although in some cases, vision might improve following the procedure, in most cases, it remains unchanged. In a few cases, there can be a loss of vision.

Sometimes your eye doctor might combine the trabeculectomy with cataract surgery. In such cases, be visual improvement might be seen.

Risks

Though trabeculectomy is generally a safe and effective procedure, some risks are involved with it, which include:

  • Postoperative infection
  • Drooping eyelid
  • Bleeding
  • Scarring
  • Double Vision
  • Low IOP
  • Developing a hole near the operating site

 

In some severe cases, some people can experience the following:

  • Hemorrhaging inside the affected eye
  • Very rarely, loss of the eye itself
  • Choroidal detachment
  • Vision Loss

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