Trabeculectomy

Trabeculectomy

Ophthalmology Services

What is Incisional Surgery (Trabeculectomy) for Glaucoma?

An incisional surgery (otherwise known as trabeculectomy, or glaucoma filtration surgery) is a medical procedure that involves removing a tiny piece of the sclera, the white section of the eyes, to create an opening. This newly-formed gap serves as a drainage hole for eye fluids known as aqueous humour – causing a small blister known as a bleb to begin forming around the opening. This helps lower eye pressure and mitigates the potential damage to the optic nerves caused by glaucoma

Immediately following the filtration surgery, antibiotics are applied onto the surface of the eye in order to prevent the possibility of infections. The eyelid is then taped shut, and an eye shield is used to cover it – patients will be expected to continue wearing the eye shield when they sleep for up to a month. The use of corticosteroid medicines is also recommended to manage inflammation throughout a duration of one to two months.

Additionally, doctors may request patients to attend regular check-ups after the surgery so that they are able to observe the efficacy of the bleb in draining fluids. If eye pressure in the operated eye continues to be problematic, doctors may cut stitches near the bleb to help aid the flow of the fluids.

What is Incisional Surgery (Trabeculectomy) for Glaucoma?

An incisional surgery (otherwise known as trabeculectomy, or glaucoma filtration surgery) is a medical procedure that involves removing a tiny piece of the sclera, the white section of the eyes, to create an opening. This newly-formed gap serves as a drainage hole for eye fluids known as aqueous humour – causing a small blister known as a bleb to begin forming around the opening. This helps lower eye pressure and mitigates the potential damage to the optic nerves caused by glaucoma

Immediately following the filtration surgery, antibiotics are applied onto the surface of the eye in order to prevent the possibility of infections. The eyelid is then taped shut, and an eye shield is used to cover it – patients will be expected to continue wearing the eye shield when they sleep for up to a month. The use of corticosteroid medicines is also recommended to manage inflammation throughout a duration of one to two months.

Additionally, doctors may request patients to attend regular check-ups after the surgery so that they are able to observe the efficacy of the bleb in draining fluids. If eye pressure in the operated eye continues to be problematic, doctors may cut stitches near the bleb to help aid the flow of the fluids.

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.

Meet our Specialist

Dato’ Dr Linda Teoh Oon Cheng

Designation
Consultant Ophthalmologist and Glaucoma Surgeon
Specialty
Ophthalmology






Dr Lee Ming Yueh

Designation
Consultant Ophthalmologist and Glaucoma Surgeon
Specialty
Ophthalmology