A trabeculectomy is a surgical procedure to treat glaucoma. Glaucoma occurs when the fluid your eye produces, called aqueous humor, is unable to drain normally. This causes the intraocular pressure (IOP) to increase over time, possibly resulting in vision loss or blindness if left untreated.
A Trabeculectomy is a surgical procedure to treat glaucoma. Glaucoma occurs when the fluid your eye produces, called aqueous humor, is unable to drain normally. This causes the intraocular pressure (IOP) to increase over time, possibly resulting in vision loss or blindness if left untreated.
Trabeculectomy lowers the intraocular pressure (IOP) inside your eye. This can slow or stop the vision loss caused by glaucoma. Your doctor may recommend a trabeculectomy if your IOP is unresponsive to standard glaucoma treatments like prescription eye drops or medication.
Trabeculectomy is used to create a new channel, or “bleb,” through which fluid can drain from the eye. Restoring the eye’s ability to drain fluid should result in lowered IOP.
Intraocular pressure may be lowered by allowing drainage of aqueous humor from within the eye to the following routes:
(1) filtration through the sclerostomy around the margins of the scleral flap into the filtering bleb that forms underneath the conjunctiva,
(2) filtration through outlet channels in the scleral flap to underneath the conjunctiva,
(3) filtration through connective tissue of the scleral flap to underneath the conjunctiva, into cut ends of Schlemm’s canal,
(4) aqueous flow into cut ends of Schlemm’s canal into collector channels and episcleral veins and
(5) into a cyclodialysis cleft between the ciliary body and the sclera if tissue is dissected posterior to the scleral spur.
Your procedure will be completed in the operating room, and it can be done under either local or general anesthesia. If you receive local anesthesia, your eye will be numbed. If given general anesthesia, you’ll be given an IV for sedation. If you’re getting local anesthesia, your doctor may have given you a sedative to take ahead of time to make it easier to relax.
Your eye will be numbed, cleaned, and fitted with a lid speculum to hold it open. Then, you’ll be covered in a drape that exposes nothing but your eye. During the procedure, you’ll know the surgeon is operating, but you shouldn’t be able to feel anything.
Your surgeon will open a bleb in the top of your eye. This will be done beneath your eyelid, so it won’t be visible after the procedure. Once the new drainage site has been created, your surgeon will place sutures near the site that are meant to hold the “flap” over the bleb open, as the site must not reseal during the healing process. Your stitches will not dissolve and will need to be removed by your doctor within about two weeks.
Surgery should last between 45 and 60 minutes. After the procedure, your eye will be patched and shielded until your follow-up appointment with your surgeon the next day.
Long-term, trabeculectomy has been proven to have a high success rate. It’s estimated that 90 percent were successful, with two-thirds of individuals no longer needing medication to control the condition afterward.
Approximately 10–12 percent of people who receive a trabeculectomy will require a repeat procedure. Research indicates that about 20 percent of trabeculectomy procedures don’t control IOP longer than 12 months, and 2 percent of procedures fail every year after that time frame. People who have the highest risk for this include those who have artificial lenses and those whose blebs become encapsulated.
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