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Glaucoma Filtration Surgery (Trabeculectomy)

Glaucoma is a group of eye diseases that damage the optic nerve, usually as a result of high intraocular pressure.

While there is no cure for glaucoma, trabeculectomy surgery can lower the pressure in your eye. Doing so can prevent, slow down or halt vision loss.

What is the trabeculectomy procedure?

During trabeculectomy surgery, a new drainage point is constructed to help fluid drain from inside the eye to outside. The new drainage site permits fluid to flow into a pocket behind the cornea’s transparent tissue, creating a small blister or ‘bleb.’ The bleb is hidden under the eyelid, so is usually not visible.

Aqueous humor is a fluid that is produced inside a healthy eye. This fluid collects waste products from inside the eye, then usually drains out of the eye via a channel known as the anterior angle. For a person with glaucoma, either too much fluid is produced or the drainage system is not operating fully, and unable to keep up with the fluid production. This imbalance can lead to a buildup of pressure in your eyes, putting your vision at risk.

Ocular drops that decrease fluid production or improve drainage are frequently used to reduce eye pressure. This balance can also be improved by a trabeculectomy procedure, as it allows surplus fluid to quickly drain and be absorbed by the tissues surrounding it.

The goal of a trabeculectomy procedure is not to improve vision or cure glaucoma. It’s meant to lower eye pressure and slow the progression of the disease. Based on the type and severity of glaucoma, some patients may be able to stop, or reduce, the number of glaucoma medications they take, while others may still need to continue with the same glaucoma medication.

What to Expect With a Trabeculectomy Procedure


Once you and your eye doctor have decided trabeculectomy surgery is a good fit for you, you’ll either meet with a preoperative scheduling nurse or your eye doctor, who will give you detailed instructions on how to prepare for the upcoming surgical procedure.

The Procedure

After eye drops have been placed in the eye, your eye will be ‘prepped’ and cleaned. A ‘lid speculum’ will keep your eye open during surgery, so you won’t have to worry about blinking. To keep you entirely comfortable, some surgeons may administer sedating drugs through an IV (intravenous) line.

Basically, a flap in the sclera (the white part of the eye) is made underneath the upper eyelid, creating a pathway to allow fluid to drain, which lowers eye pressure.

Recovery after Trabeculectomy

After a trabeculectomy surgery, the eye generally is covered by an eye patch and protected by a plastic shield overnight. On the morning following the surgery, the patch is removed and the eye is examined by your eye doctor. Eye drops are then prescribed to prevent infection, reduce inflammation and relax the muscles in the eye. In some cases, medication may be prescribed to help reduce inflammation even more. It’s critical to follow your eye doctor’s instructions since they can make a big difference in the procedure’s success.

Your eye doctor will closely monitor your eye and examine you frequently for several weeks after surgery and continuously provide you with updated instructions and medications based on your recovery. The healing process may take up to 12 weeks. It’s not uncommon for your intraocular pressure and vision to vary throughout this time. Around 6-8 weeks after surgery you will be able to modify your eyeglass prescription.

Schedule an appointment with VisionMD Eye Doctors in Glenn Dale to learn more about trabeculectomy and whether it is right for you.