It is a filtration operation to create a new outflow channel for the aqueous fluid to drain out of the eye and ultimately reduce the eye pressure. The newly formed outflow channel can be seen in the upper part of the eye and is usually covered by the eyelid. It is known as the bleb. In most cases (95%), it achieves the target eye pressure without the use of topical medication.
Before the surgery, your consultant may commence you on anti-inflammatory drops to “maximise” the surface of the eye and ultimately improve the success of the operation.
During the surgery, the eye will be anaesthetised with either a local anaesthetic injection or general anaesthetics. The surgery itself can take anything from 45minutes to 1 hour during which the outer covering of the eye (conjunctiva) is opened and a partial thickness flap door is created in the white part of the eye (sclera). A passageway is then formed between the anterior chamber and the newly formed drainage channel for the aqueous fluid to flow through. The flap is then secured with “releasable sutures” that can later be used to tweak the eye pressure, and the conjunctival opening is sutured.
At the end of the surgery, you will be given an antibiotic and anti-inflammatory injection to prevent any infection or scarring. The eye is then normally covered with a cotton pad and a protective shield.
After the operation you will be asked to avoid any rubbing of the eye, any heavy lifting, strenuous exercise, bending down, getting water into the eye or straining in any form as this could cause the pressure in the eye to rise. You will be told to stop any previous glaucoma drops you were using and given intensive topical steroids (8 per day) and antibiotics (4 per day) to use for 4-6 weeks.
The vision is usually blurred for the first few days following the trabeculectomy operation but as long as it is not worsening, this is completely normal. The eye will feel uncomfortable due to the sutures but not painful and again this tends to subside in the first week. The eye will look red and there may be some mild watering or clear discharge in the first 1-2 weeks. You will be having regular visits and an intensive post operative drop regime for the first 4 weeks. Once the initial period passes, the vision will return to the pre-operative level, the pressure will be within target and you will come off all topical medication in the operated eye.
You will need a review on day 1, week 1, week 2, week 3-4 and then, depending on how well the bleb is healing, week 6. At this point, the topical steroids drops will be tailored over the following 2-4 weeks and you will be seen once all drop courses have been completed.
Glaucoma surgery prices range from £3000 – £4500 depending on the complexity of treatment
The success rate of trabeculectomy is 95%. It is a well established surgery and with the Moorfields safe surgery technique, it has been refined further and today is considered the gold standard filtration surgery in glaucoma nationwide. But, as with every operation, there is always a small risk of complications, most of which are mild and temporary. These include:
Below you can find out the answers to some of the commonest questions our expert surgeon, Ms Sally Ameen is asked about trabeculectomy.
The lifespan of a trabeculectomy operation is usually 15-20 years. This is depending on a number of factors: the age of the patient when the surgery is performed, the anti-scarring agent used during the surgery, the post op healing process and if the eye is subjected to any further surgeries.
The eye can feel uncomfortable for the first week after a trabeculectomy surgery. The discomfort is mild to moderate but does not cause severe pain. As the eye heals and recovers, the discomfort subsides.
Legally, this depends on the level of vision and visual field defect that you have affecting BOTH eyes (and not just the operated eye). If the unoperated eye has good vision and minimal visual field defect, then legally you are allowed to drive irrespective of the operated eye. You may want to refrain from driving for a few days after the surgery as the eyes would be adjusting to the change in the vision and you may not feel confident to drive until that settles.
The operation usually settles within 3-4 weeks. Once healed, the eye pressure will remain stable without the need to use glaucoma drops and the disease is controlled and any further progression would be stopped.
Sally Ameen is part of OCL Vision, a group of elite eye surgeons offering consultation, treatment and surgery onsite in one place. Choose from our central London location (close to Harley Street), Chiswick or Harrow.
Our annual care package costs £950 and covers one year of unlimited glaucoma consultations and diagnostics required to monitor eye pressure.*
*Surgery and drops are not included in this price.
The most common surgery type performed by Sally Ameen is MIGS (minimally invasive glaucoma surgery). This group of operations has been pioneered to reduce the chance of complications following surgery, and is ever-evolving. available.
Sally Ameen recognises the importance of each patient’s individual journey, and the tailored care they require. She will always do everything in her power to save her patients’ sight, using her expert knowledge and surgical skills.
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