trabeculectomy

Indications

• glaucoma

Procedure

• surgical creation of a small hole in the sclera covered by a thin trap-door in the sclera
• aqueous humor drains through the trap-door to a small reservoir reservoir between the sclera & conjunctiva to form a small drainage bleb that is usually hidden under the upper eyelid.
• the trap-door is sutured in a way that prevents aqueous humour from draining too quickly
• by draining aqueous humour, trabeculectomy reduces pressure on the optic nerve & prevents or slows further damage & further loss of vision in glaucoma
• control of the eye pressure with a trabeculectomy will not restore vision already lost from glaucoma
• trabeculectomy often performed under local anaesthesia, though it may also be performed under general anaesthesia

Complications

• intraocular pressure becomes too low
• eye infection (1 in 250)
• worsening of cataracts

Management

• anti-inflammatory ophthalmics, including ophthalmic glucocorticoids, is beneficial for control of intraocular pressure after trabeculectomy
• antimicrobial ophthalmic solution & ointment should be used continuously for a period after trabeculectomy
  • long term, use antimicrobial ophthalmic solution &ointment as appropriate based on risk for bleb-related infection

More general terms

• eye surgery; opthalmologic surgery; ocular surgery
• surgical resection (excision)

Additional terms

• trabeculotomy