Glaucoma
What is a trabeculectomy?
A trabeculectomy is glaucoma surgery that creates a small controlled channel through the wall of the eye, allowing fluid to drain into a reservoir under the thin surface membrane. It is one of the most effective ways of reaching a low eye pressure. It is usually a day case under local anaesthesia, with close follow up over the first months.
The operation
Working under an operating microscope, the surgeon lifts a thin flap in the white of the eye near the upper edge, removes a tiny piece of tissue to open a route out of the eye, and lays the flap back so that fluid seeps out at a controlled rate. A small blister called a bleb forms under the conjunctiva, usually hidden by the upper lid. Medicines that limit scarring are often used to keep the channel working.
Recovery
- Vision is commonly blurred for several weeks and gradually improves
- Anti inflammatory and antibiotic drops are used for a period of weeks to months
- Frequent early reviews allow stitches to be adjusted or released to fine tune pressure
- Avoid heavy lifting, straining, swimming, dusty environments and rubbing the eye during healing
- Report any increase in pain, redness, discharge or loss of vision without delay
Risks to weigh
Possible problems include pressure that ends up too low or too high, scarring that closes the channel, bleeding, cataract forming or progressing faster, and infection of the bleb, which can occur even years later and needs urgent treatment. These risks are uncommon, and they are balanced against the risk of losing more vision if pressure stays high. Outcomes cannot be guaranteed.
Long term care
A trabeculectomy needs lifelong review. The bleb is checked, pressure is monitored and fields and scans are repeated so that any renewed progression is picked up. Some eyes later need additional drops or a further procedure.
When to seek urgent assessment
- A red, painful eye with blurred vision or discharge after trabeculectomy, at any time including years later, which needs same day assessment
Frequently asked questions
- Will the bleb be visible?
- It sits under the upper eyelid and is usually not noticeable to others.
- Can trabeculectomy be repeated?
- Yes, a further trabeculectomy or a drainage device can be considered if the first channel scars closed.
Concerned about these symptoms?
Arrange an eye examination with our consultant ophthalmologist in Garki, Abuja.
Care at Standard Eye
Related answers
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Return to all glaucoma answers.