OPHTHALMOLOGY

Q:My doctor is going to perform a trabeculectomy surgery for my glaucoma that is uncontrolled with medication. What’s involved in this surgery? A: Trabeculectomy, also known as glaucoma filtration surgery, is the most common surgical non-laser procedure performed for glaucoma. It is generally recommended for patients who have glaucoma that continues to progress despite the use of medications and/ or laser treatments. Trabeculectomy surgery is an out-patient procedure that is performed under local anesthesia in an operating room and takes about 45 minutes. During this surgery, the surgeon creates a new drainage site to facilitate drainage of fluid from the eye since the natural drain inside the eye is not draining sufficiently. Instead of draining into the normal drainage site of the eye, the trabecular meshwork, this surgery allows fluid to drain into a new space, a bleb, that is completely covered by the white outer covering of the eye. Since the surgery is usually performed near the top of the eye, the area of surgery cannot be seen afterwards because it is behind the upper eyelid. The fluid diverted to the bleb is re-absorbed by surrounding blood vessels. When successful, this procedure will lower your eye pressure minimizing the risk of vision loss from glaucoma. During the post-op period, special eye drops will be needed for healing and some activities may be restricted for a few weeks. You will have regular follow-ups to check on the healing progress and to monitor the IOP in the operative eye. Recovery time after a trabeculectomy varies from one individual to another as every eye heals differently but is generally 6 to 8 weeks. The goal of the trabeculectomy surgery is to eliminate the need for glaucoma drops but depending on the success of the surgery, drops sometimes might need to be restarted. It is very important to keep all post-operative and regularly scheduled continuing care appointments so that your eye doctor can check your progress and develop the most effective management plan for your glaucoma.