Jump to topic
Trabeculectomy is a surgical procedure that lowers the pressure inside your eye, called intraocular pressure (IOP).
Eye pressure increases when the fluid inside of your eye (aqueous humor) cannot drain properly through the trabecular meshwork. The trabecular meshwork is a sponge-like structure located in the drainage angle, where the majority of aqueous humor leaves the eye. High IOP causes damage to your optic nerve, which results in progressive vision loss starting with your peripheral (side) vision.
Glaucoma therapies aim to lower eye pressure, which in turn slows down the progression of the disease. Many patients begin treatment with medicated eye drops. The surgeon may also perform a laser procedure to increase fluid drainage. Trabeculectomy is often performed if the eye pressure is not low enough with these therapies.
Jump to topic
Trabeculectomy aims to create an alternate channel for aqueous fluid to leave the eye if the trabecular meshwork becomes blocked. This way, fluid does not build up inside your eye. Trabeculectomy surgeries take about an hour and are usually performed under local (sometimes general) anesthesia.
During the procedure, the surgeon takes the following steps:
Serious complications are rare with trabeculectomy. Some potential complications of this surgery include:
As with other types of eye surgeries, trabeculectomy may also increase your risk for cataract formation.
Recovery usually takes a few weeks, up to about two months. Here are some things to expect during this period:
Generally, trabeculectomies have a reasonably high success rate. A successful procedure means the eye pressure stays normal without additional treatments or medication.
Studies find that, on average, eye pressure drops by about 48% after trabeculectomy. The surgery remains successful for about 86% of patients one year after surgery. After three years, approximately 70% of trabeculectomies are still successful. At five years, that number is closer to 40%.
Once a trabeculectomy fails, a second trabeculectomy or other glaucoma surgery may be necessary. In other cases, some people must continue their glaucoma medication even after trabeculectomy surgery.
There are alternative glaucoma surgeries to trabeculectomy, which include:
Chen, Yan Yun, et al. “Laser Peripheral Iridotomy versus Trabeculectomy as an Initial Treatment for Primary Angle-Closure Glaucoma.” Journal of Ophthalmology, vol. 2017, Sept. 2017, pp. 1–6., doi:10.1155/2017/2761301.
Gedde, Steven J., et al. “Three-Year Follow-up of the Tube Versus Trabeculectomy Study.” American Journal of Ophthalmology, vol. 148, no. 5, Nov. 2009, pp. 670–684., doi:10.1016/j.ajo.2009.06.018.
Gupta, Viney, et al. “Lasers in Glaucoma.” Indian Journal of Ophthalmology, vol. 66, no. 11, Oct. 2018, pp. 1539–1553., doi:10.4103/ijo.ijo_555_18.
Manasses, Demetrios T., and Leon Au. “The New Era of Glaucoma Micro-Stent Surgery.” Ophthalmology and Therapy, vol. 5, no. 2, June 2016, pp. 135–146., doi:10.1007/s40123-016-0054-6.
Nouri-Mahdavi, Kouros, et al. “Outcomes of Trabeculectomy for Primary Open-Angle Glaucoma.” Ophthalmology, vol. 102, no. 12, Dec. 1995, pp. 1760–1769., doi:10.1016/s0161-6420(95)30796-8.
Piltz-Seymour, Jody, et al. “Trabeculectomy.” EyeWiki, 26 Oct. 2015, eyewiki.aao.org/Trabeculectomy.