Trabeculectomy (Filtration Surgery) for Glaucoma

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Trabeculectomy (Filtration Surgery) for Glaucoma

Surgery Overview

During trabeculectomy—sometimes also called filtration surgery—a piece of tissue in the drainage angle of the eye is removed, creating an opening. The opening is partially covered with a flap of tissue from the sclera, the white part of the eye, and the conjunctiva, the clear thin covering over the sclera. This new opening allows fluid (aqueous humor) to drain out of the eye, bypassing the clogged drainage channels of the trabecular meshwork.

As the fluid flows through the new drainage opening, the tissue over the opening rises to form a little blister or bubble, called a bleb. The bleb is located where the sclera, or white of the eye, joins the iris, the colored part of the eye. During office visits after surgery, the doctor looks at the bleb to make sure that fluid is still draining out of the new opening. Not all blebs have to be easily seen to work.

What To Expect After Surgery

The person does not have to be admitted to the hospital. But children may stay in the hospital overnight following surgery. And in some cases, your doctor may recommend that you stay in the hospital.

Right after surgery, antibiotics may be applied to the eye. Also, antibiotics may be injected under the lining of the eyelid (conjunctiva). After surgery, the eyelid is usually taped shut, and a hard covering (eye shield) is placed over the eye.

The person wears a dressing over the eye during the first night after surgery and wears the eye shield at bedtime for up to a month. Corticosteroids are usually applied to the eye for about 1 to 2 months after surgery to decrease inflammation in the eye.

People who have a trabeculectomy without being admitted to the hospital usually have a checkup the following day with their eye specialist.

Any activity that might jar the eye needs to be avoided after surgery. People usually need to avoid bending, lifting, or straining for several weeks after surgery.

After surgery, people who have problems with constipation may need to take laxatives to avoid straining while trying to pass stools. Straining can raise the pressure inside the eye, increasing the risk of damage to the optic nerve or bleeding.

Usually there is mild discomfort after a trabeculectomy. Severe pain may be a sign of complications. If you have severe pain after a trabeculectomy, call your doctor immediately.

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