Trabeculectomy surgery

In traditional glaucoma surgery, a small guarded hole (fistula) is made to drain out fluid from inside the eye, thereby reducing the IOP. This is the most common surgery performed for glaucoma, and is known as trabeculectomy.

In this technique, a tiny guarded hole in the wall of the eyeball at the level of the junction of the cornea and the sclera is performed to allow the egress of the aqueous humor through a new alternative outflow way. The aqueous humor is directed through the tiny hole to a reservoir at the sub-Tenon/sub-conjunctival space that is called filtering bleb. The sutures aim to control the amount of flow, and from bleb, the aqueous is then absorbed through the capillaries to the blood circulation. Surgery is usually done under the superior eyelid.

After surgery, a small white coloured blister / scar can be seen in the upper part of the eye and is called a “bleb”. In most cases, the bleb remains covered by the superior eyelid and cannot be seen unless the eyelid is retracted.

Trabeculectomy surgery Fig. 1

Fig. 1. Schematic view of the filtrating surgeries aqueous drainage.

Trabeculectomy surgery Fig. 2

Fig. 2. Trabeculectomy appearance: Left photo – early postoperative period with difuse bleb and moderate conjunctiva hyperemia. Right photo – mid-term postoperative period with diffuse bleb with mild hyperemia.

World Glaucoma Association

Important message for glaucoma patients

It is important for you to get yourself regularly screened for glaucoma. If you have been diagnosed to have glaucoma, effective treatment options are now available and regular treatment and follow up can help you to preserve your vision for your lifetime, avoiding unnecessary fear of going blind.

You can live happily with glaucoma and enjoy an excellent quality of life, particularly if the disease is detected early and treated in time. Always remember that once you have glaucoma, you will have to be under the care of an eye doctor for the rest of your life.

There is a lot of research going on and new treatments may become available for glaucoma in the near future.

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