Glaucoma Surgery

December 11, 2018 — by William Goldstein
Tags: Glaucoma Glaucoma Surgery Trabeculectomy

Many patients suffering from glaucoma choose to undergo a surgical procedure known as trabeculectomy. This procedure drains the aqueous humor from the eye, thereby reducing eye pressure, also known as intraocular pressure or IP in glaucoma patients.

The surgeon makes a tiny hole in the sclera, which is the eyewall. In doing so, the fluid present inside the eyes (which is different from tears) drains out from a thin trap-door that covers the sclera. The drained eye fluid goes to a small reservoir-like area just under the surface of the eye. Then, the surgeon stitches up the trap-door to ensure that the aqueous humor doesn't drain out too quickly.

The purpose of draining the aqueous humor is to reduce the intraocular pressure, which is the pressure on the patient’s optic nerves. This further helps in slowing down any further damage caused to the eyes due to glaucoma, such as loss of vision, because glaucoma is often a result of high eye pressure. It is important to note that trabeculectomy isn’t a procedure which can undo the damage caused by glaucoma and restore the patient’s vision completely. It can only reduce the pace of progression of the condition.

Trabeculectomy is one of the most common surgical procedures that glaucoma patients undergo. It is especially opted by patients who have seen no results from other forms of treatments such as medical treatments as well as laser surgeries.

Since this is a very complex and delicate procedure, it is critical that only a well-trained and experienced surgeon takes charge so that the patient can achieve the best possible results. Usually, it takes about an hour or so to complete the surgery.

What to expect after the procedure?

After undergoing trabeculectomy, most patients experience improved eye pressure for a period of about five years. In most cases, they don't need to continue with their glaucoma medications which may have been prescribed prior to the surgery. Instead, they will have to follow a new medication including steroid eye drops and antibiotic. These medications help prevent any infection and avoid inflammation.

Patients report that they don't even notice the presence of the reservoir-like area where the drained aqueous humor is stored, also commonly referred to as "bleb." If any patient feels otherwise, the surgeon can make changes to make the bleb more discreet and comfortable.

Generally, trabeculectomy provides successful results in most patients who experience a significant decrease in eye pressure.