Trabeculectomy

Trabeculectomy

Glaucoma is a common eye condition where the nerve connecting the eye to the brain is damaged as a result of increased pressure in the eye.

Should eyedrops or laser treatment not resolve the issue sufficiently, an operation called a trabeculectomy may be required in order to lower the pressure in the eye before any further irreversible damage to the eye is caused.

What is a trabeculectomy?

High eye pressure (elevated intraocular pressure) occurs when there is an imbalance between the amount of fluid produced in the eye and the amount that is drained from the eye.

A trabeculectomy is one of a number of surgical options available to lower the pressure in an eye by draining excess fluid from it.

The operation involves a surgeon making a small hole in the white outer wall of the eye (sclera), then creating a ‘flap’ to allow the excess fluid to drain in a controlled manner.

The flap created is known as a ‘bleb’. Fluid from the eye collects under the flap from where it drains naturally into the blood.  

To prevent scaring an antimetabolite is sometimes used during the operation.

A trabeculectomy is carried out under local anaesthetic, meaning you are awake but your eye and the area around it is numb so that you don’t feel any pain.

In some cases, the surgery is done under general anaesthetic, but this will be decided in advance by your consultant and the anaesthetist and after consultation with you.

Before the surgery begins, anaesthetic eye drops will be put into your eye in order to numb it.

You will then be given an injection of local anaesthetic to further numb the area around the eye (this may cause a slight stinging or burning sensation for a short period of time but will quickly pass). Once the local anaesthetic has taken full effect, your surgeon will carry out the operation.

During the surgery, anti-scarring medication is usually applied to the area operated on. This helps to reduce the risk of scar tissue forming, which could potentially block the newly created drainage channel. 

Once the operation is complete, a padded patch will be placed over your eye for protection.  

You will be able to return home the same day, once everything has been thoroughly checked by the surgical team at St Joseph’s.

You will have a number of appointments booked with us following the operation, so that we can assess your recovery and check everything is healing nicely.

Should you have any queries or concerns at any stage between these follow-up appointments, you should contact our ophthalmology team for help.   

Due to the nature of the surgery, you will need to take some time off work in order to give yourself time to adequately recover. You will usually be able to return to work within two weeks of the surgery.  

You should not drive too soon after the operation as you may experience blurry vision for a few days. Your surgeon will be able to give you specific guidance about when you can start to drive again.  

Gentle exercise is usually okay, but strenuous physical activity and swimming should be avoided for the first month or so. If you have any queries about when you can return to regular physical activity, please speak with your consultant for further information and help.  

You will often be given medication to aid healing, prevent infection and to reduce pain, and it is important you follow any instructions you are given about using these and continue to use them until told by your doctor to stop.

It can take up to 6 weeks to fully recover from a trabeculectomy.

Any surgical procedure carries risks and the potential for complications, including:

  • Infection,
  • Pain,
  • Allergic reaction to the anaesthetic,
  • Formation of blood clots.

Complications and risks specific to a trabeculectomy include:

  • Discomfort in the eye,
  • Bruising of the eye and the area surrounding it,
  • Scarring on or around the eye (although the anti-scarring medication used helps to reduce the risk of this),
  • A sudden drop in the pressure in the eye,
  • Blurring of your vision,
  • Increased long-term risk of developing cataracts.

The above risks are intended as guidelines only and are not exhaustive. We always recommend that you talk with your consultant about potential risks and complications before you decide to have any eye surgery.

Our experienced eye consultants can provide you with a thorough eye examination to determine the extent and cause of your glaucoma, and then advise you whether a trabeculectomy, or alternative eye surgery, is advised.

Should surgery be required, you will be given the very finest care at all times, from pre- to post-treatment, to ensure your eye health is restored and maintained.   

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