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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 [1]
- 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 [1]
Related
trabeculotomy
General
eye surgery; opthalmologic surgery; ocular surgery
surgical resection (excision)
References
- Kiuchi Y, Inoue T, Shoji N, Nakamura M et al
The Japan Glaucoma Society guidelines for glaucoma 5th edition.
Jpn J Ophthalmol. 2023 Mar;67(2):189-254
PMID: 36780040
https://link.springer.com/article/10.1007/s10384-022-00970-9
- International Glaucoma Association
Trabeculectomy
https://www.glaucoma-association.com/about-glaucoma/treatments/surgery/trabeculectomy/