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Trabeculectomy

If you have been diagnosed with glaucoma, you’ll know that there are many treatment options available. If you have high intraocular pressure, your doctor at Eye Physicians of Long Beach may recommend a trabeculectomy. Typically, a trabeculectomy will only be performed when other medical treatments or certain laser surgeries have not been enough to significantly lower your intraocular pressure. Untreated glaucoma eventually results in loss of vision, and even blindness if you can’t get your pressure low enough.

What is a Trabeculectomy?

A trabeculectomy is a surgical procedure that is performed to reduce intraocular pressure. To perform a trabeculectomy, an anesthesiologist will numb your eye so that you can’t feel anything besides slight pressure during the surgery. After using anesthetic drops to numb your eye, an anesthetic injection will be placed around your eye. This is to ensure that your eye becomes fully numb, as well as to reduce the eye’s ability to move during surgery. Once the eye is properly anesthetized, the surgery can begin.

Your surgeon will start by creating a tiny hole in the eye wall, known as the sclera of the eye. The hole in the sclera is then covered up by a very thin flap or a “trapdoor”. This is created to let the fluid that is in the eye flow in a controlled manner. The fluid of the eye (aqueous humor) then moves from inside of the eye through the trapdoor that has been created and remains under the conjunctiva of the eye. In this clear membrane of the eye, a blister or “bleb” is formed under the upper part of the eyelid. With this bleb in place, the aqueous humor is controlled and able to flow properly. The goal with creating the bleb and trapdoor is to eventually allow eye pressure to decrease to an appropriate level. A trabeculectomy surgery typically takes about 45 minutes to an hour to complete.

Recovering After a Trabeculectomy

After a trabeculectomy has been performed, it is important to give your eyes plenty of time to heal and recover. At first, you will notice that your eye may be swollen and red. This is normal! The redness and swelling, as well as eyelid droopiness, will subside within a few weeks, but it could take as a long as a couple of months as well. Like any surgical procedure, everyone heals at a different pace. Your eye will either be padded, or you will wear a clear eye shield if you cannot see well out of your eye that wasn’t operated on. You will not be able to drive after a trabeculectomy, especially if you were put under general anesthesia. Most patients are able to go home the day of surgery, or just one short day later.

After your post-operative appointment, you will be prescribed eye drops. These will typically be an anti-inflammatory steroid drop, as well as an antibiotic eye drop. Make sure to use these as directed by your eye doctor at Eye Physicians of Long Beach! It may seem annoying or frustrating, but they are an extremely important part of the recovery process after a trabeculectomy to prevent infection or other complications.

During your recovery process, you’ll also be required to attend weekly appointments at Eye Physicians of Long Beach, at least for the first four weeks after your procedure. This is to ensure your eye pressure is remaining steady, and is not too high or too low. During these visits, your sutures will be removed, and you may be prescribed an additional steroid to help adjust pressure of the eye. In addition to these visits, you must avoid any kind of strenuous activity like running, tennis, swimming and any full-contact sports. You should also avoid any potential activities that could result in head or face injuries, as they may damage the results of your trabeculectomy.

Glaucoma After a Trabeculectomy

Although there is no cure for glaucoma, undergoing a trabeculectomy lowers the intraocular pressure in patients significantly. In fact, even twenty years after a trabeculectomy, many patients report that their glaucoma is still under control, and their eye pressure continues to be lowered. Many also no longer require the use of glaucoma medication to regulate their intraocular pressure levels. This depends on each individual patient, but for those who have glaucoma that is non-responsive to other surgeries and treatment options, a trabeculectomy is an important option to consider.

If you have glaucoma and are interested in learning more about a trabeculectomy and if it could be right for you, contact our Long Beach office to schedule an appointment with one of our talented doctors!

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