Glaucoma Filtration Surgery (Trabeculectomy)

What is the trabeculectomy procedure?

Trabeculectomy surgery is when a new drainage site is created to help filter the fluid inside the eye. The new drainage site allows for fluid to flow into a space under the clear tissue or conjunctivae of the eye forming a small blister or bleb.

Inside a healthy eye, there is a fluid known as aqueous humor that is regularly created and drained out of the inside of the eye. When a person has a glaucoma, there is either not enough fluid being produced or the drainage cannot keep up with the fluid production. This imbalance can cause built-up pressure, putting your eye health at risk. Special eye drops are often used to lower eye pressure by increasing fluid production or improving its drainage. The trabeculectomy procedure is also designed to improve this balance. It allows excess fluid to be drained and then absorbed by nearby tissues.

In order to prevent scarring at the drainage site in filtration surgery, additional anti-scarring medication is used at the time of surgery. These medications are known as anti-metabolites such as 5 Fluorouracil (5-FU) or Mitomycin C (MMC).

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Trabeculectomy surgery is an outpatient procedure and is performed at either a local surgical facility or hospital. Local anesthesia will be provided as well as IV sedation that is administered by an anesthesiologist. Upon completion of the surgery, an eye patch will be put into place, which will be removed at your first post-operative appointment. For the first 4 to 8 weeks, you will be required to use eye drops and frequently return for appointments so we can monitor your progress. Since healing will vary based on the individual, additional procedures or injections may be necessary to achieve optimal results.

Please note, the goal of the trabeculectomy procedure is not to improve vision or cure glaucoma. The surgery is meant to lower eye pressure to slow the progression of the disease. Some patients are able to stop taking some of their glaucoma medications, but based on the type and severity of the disease, you may need to continue with glaucoma medication.

What are the main risks of the trabeculectomy?

The most common complications associated with filtration surgery including blurred or decreased vision, worsening of a pre-existing cataract, infection, bleeding, corneal swelling, and double vision. Finally, there is a chance further surgery will be required.

If you would like to learn more about trabeculectomy, and whether it is right for you, please contact Eye Doctors of Washington to set up an appointment.

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