Usage and associated risks of trabeculectomy

A trabeculectomy may be recommended as an alternative treatment for both open-angle glaucoma and closed-angle glaucoma. However, the operation is typically reserved in cases where prior medication and laser treatments have proven ineffective in reducing eye pressure sufficiently. This is because recovery periods for filtration surgeries can vary anywhere from two to six weeks.

The primary risk associated with glaucoma trabeculectomy procedures is the scarring of the surgical opening - which occurs because your body sees the opening as an injury and attempts to heal it. Unfortunately, this scarring over the bleb interferes with the fluid drainage process. This issue is most prominent in younger patients, as they generally have more robust healing systems.

Thankfully, there are several medications to aid in slowing down the healing process, including 5-FU and mitomycin-C. Additionally, a trabeculectomy surgery can be done multiple times if required.

On rare occasions, there is also the added risk of severe complications following eye surgery. This includes:

• Eye infections
• Partial or complete loss of central vision
• An excessive drop in eye pressure
• Bleeding in the eye

Preparing for trabeculectomy

During the consultation, our ophthalmologist will examine the damaged eye and analyse if any pre-existing conditions may lead to complications during and after the trabeculectomy procedure. Our ophthalmologist may also conduct a general check-up to manage any underlying conditions before the surgery, especially if you will be going under general anaesthesia.

The ophthalmologist may require you to fast for 12 hours before the procedure since local anaesthesia is involved.

The recovery process after trabeculectomy

Patients are usually not required to be admitted into the hospital post-surgery.

Initially, you may experience some minor side-effects on the operated eye throughout the duration of this recovery period, including:

• Blurred vision
• Redness
• Irritation
• Tearing
• Swelling

Most patients can expect these symptoms to diminish within a week or two of their incisional surgery, and to have fully recovered by week six.

To ensure a smooth recovery, it is recommended that you initially avoid any action that may cause strain on your eyes. This includes activities such as strenuous exercise, driving, bending, reading books or newspapers, watching TV and using screen-based devices. Within a few days, patients will be able to resume these daily activities – however, we recommend that you continue to do so in moderation.

Contact lens users should consult their eye doctor if there are any problems following surgery – as there may be a need to change their contact lenses or glasses. This is because the bleb can result in fitting issues. While gas permeable or soft contact lenses may be worn, patients must take special care in avoiding infection of the bleb.

If you are ever unsure of your recovery progression or if you experience any sudden pains, check in with EYECENTRIC, our eye specialist centre at Subang Jaya Medical Centre (SJMC). We will advise you on what steps to take to mitigate the pain, as well as recommend and prescribe the appropriate pain medicines.

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