Trabeculectomy for glaucoma is the gold standard for those with advanced or rapidly progressing glaucoma. As the population ages, we can expect an increase in the number of patients in their 80s and 90s with glaucoma. Many of these patients will require pressure lowering in the single digits, and only trabeculectomy can achieve intraocular pressure readings in such a low range. Trabeculectomy for glaucoma: what to expect.
What Is Glaucoma?
Glaucoma is an eye condition that causes high eye pressure and damage to the optic nerve resulting in loss of vision. People with glaucoma slowly lose their peripheral vision and if not treated, they can lose their vision entirely.
The best treatments for glaucoma involve lowering eye pressure to prevent vision loss. Most patients use eye drops to lower their IOP. In-office laser therapy can also help. When these therapies are unsuccessful, Dr. Hecht may recommend trabeculectomy.
No surgical procedure can permanently cure glaucoma or bring back vision already lost.
What to Expect Before Trabeculectomy
Trabeculectomy is an outpatient procedure and a very delicate surgery that uses local anesthetic, needs an anesthesiologist, and takes approximately one hour to complete. The goal is to create another passageway for fluid to drain out of the eye in order to lower eye pressure.
What to Expect During Trabeculectomy
The eye is numbed with drops and you will also receive other relaxing medications through an IV.
- Dr. Hecht creates a tiny opening in the skin that covers the eye surface, known as the conjunctiva. The sclera, or your eye’s white section, can be seen through the opening.
- A flap is created in the white sclera producing an opening into the interior part of the eye. Another opening might be needed at the border of the iris. This keeps the tissue of the iris from interfering with the new drain.
- Sutures are utilized to reattach the border of the flap to the sclera which helps to control how quickly the fluid drains from the eye. This directly affects the final IOP.
- The conjunctiva is also sutured to enclose the flap and drainage.
What to Expect After Surgery
You will need someone to drive you home. Your eye may feel sore and like there is an eyelash in it. Tylenol will help most discomforts.
You will have blurry vision for a few days or up to several weeks. A plastic shield should be worn while sleeping for at least two weeks.
You should be able to return to work within a few weeks, but physical activities will be restricted.
Whenever outside, wear sunglasses to shield your eyes from the sun and wind.
Dr. Hecht will provide steroid and antibiotic drops to help with healing and to protect from infection.
Keep up with all follow-up appointments as recommended.
Eye pressure will be lowered for several years and the need for previous eye drops will be reduced or eliminated.
Contact Hect Eye Institute at (310) 370-5648 if you have additional questions or concerns about getting trabeculectomy surgery. If you are seeking glaucoma treatment, request an appointment at our office in Lawndale, Beverly Hills, or Marina del Rey.
