What is a Trabeculectomy?

In the initial days following your trabeculectomy, it's normal for your eye to be red and swollen, and your eyelid may droop slightly. This is temporary and typically resolves over a few weeks or months.

The drainage bleb created during the procedure is usually not visible to others. You might be able to see it if you lift your upper eyelid while looking in a mirror. Most patients don't feel any sensation from the bleb.

It's important to continue taking all your usual eye drops and medications as prescribed. If you are on blood thinners, please let Mr Trikha and the team at Grosvenor eye clinic know and they will advise you accordingly.

If you are taking Warfarin, please have your INR level checked at least two weeks before the operation to ensure it is within the appropriate range.

Trabeculectomy is usually performed using local anaesthesia, meaning you'll be awake but your eye will be numbed. This involves an injection around the eye, which also helps to prevent eye movement during the procedure.

While local anaesthesia is generally preferred, general anaesthesia (where you are asleep) is also an option. If you feel anxious about the surgery, you can discuss the option of mild sedation with Mr Trikha. This can help you relax during the procedure.

During your trabeculectomy, Mr Trikha may apply a medication called Mitomycin C to the surface of your eye for a few minutes.

Although originally used in cancer treatment, Mitomycin C is also helpful in glaucoma surgery because it reduces scarring.

Scar tissue can interfere with the long-term success of a trabeculectomy by blocking the new drainage channel. After a short application time, the Mitomycin C is thoroughly washed away with sterile water.

You'll likely go home the same day or the day after your surgery, but will need a follow-up exam the next day. Arrange for a ride home if you have limited vision in your other eye or have had general anaesthesia.

Expect blurred vision and some discomfort, which usually improves over a few weeks. Full recovery and stable vision may take 2-3 months.

You'll wear an eye shield at night for the first two weeks and have stitches removed at a follow-up appointment 2-3 weeks after surgery.

It is common for vision to be blurry and the eye to feel uncomfortable after surgery. The duration of blurred vision varies, but it may be especially pronounced for the first 1-2 weeks, gradually improving afterwards. It can take 2-3 months for the eye to feel fully normal and for vision to completely stabilise.

Patients are typically advised to wear an eye shield at night for the first two weeks to protect the surgical site from accidental injury during sleep.

Post-surgery soreness in the eye is partly caused by the procedure itself and partly by the stitches. These stitches do not dissolve and are usually removed in the clinic 2 to 3 weeks after surgery. The removal process is quick (around 2-3 minutes) and done under local anaesthesia with eye drops. The eye generally becomes more comfortable once the stitches have been removed.

You'll be given prescription eye drops to use regularly after your surgery, starting the day after your follow-up exam. You won't need to use them the first night after your operation.

Unless otherwise instructed, stop using any glaucoma medications (including Acetazolamide/Diamox tablets) in the operated eye the night after surgery. However, continue using any eye drops for your unoperated eye as prescribed.

Your post-surgery eye drops will typically include an antibiotic (like chloramphenicol) and a steroid to reduce inflammation (like dexamethasone). You'll use the steroid frequently at first (about every 2 hours during the day), and the antibiotic four times a day.

You'll have regular follow-up appointments, usually weekly for the first month, to monitor your eye pressure and healing. These visits may be more frequent if your eye pressure is too high or too low.

During these appointments, Mr Trikha may adjust the stitches or give you injections around the eye to manage your eye pressure and healing. These injections contain steroids or 5-Fluorouracil (a medication that helps control scar tissue) and are administered with numbing eye drops during your clinic visit.

Take it easy for the first few weeks after your surgery. Avoid strenuous activities like swimming, tennis, jogging, and contact sports. It's perfectly fine to watch television, read, or engage in other relaxing activities that don't strain your eye.

While you are allowed to fly after your trabeculectomy, remember that you'll need several follow-up appointments to monitor your eye pressure. Plan your travel accordingly to ensure you can attend these important visits.

When you can return to work after your trabeculectomy depends on your job, your vision in your other eye, and the healing of your operated eye.

If you have an office job and a smooth recovery, you might be able to return after about 2 weeks. However, if your work involves heavy lifting, dusty environments, or manual labour, you may need a month or more off to allow for proper healing.

You might be able to resume wearing contact lenses around 8 weeks after your trabeculectomy, sometimes sooner. However, not everyone can wear contacts after this procedure.

If wearing contact lenses is essential for you, discuss this with Mr Trikha before your trabeculectomy. Alternative glaucoma treatments might be more suitable if you cannot go without contacts.

It typically takes 2-3 months for your eye to fully recover and feel normal after a trabeculectomy, though more complex cases may take longer. Once your eye has healed, you'll likely need an updated eyeglass prescription, as your vision may have changed slightly due to the surgery.

Trabeculectomy is highly effective at lowering eye pressure, often eliminating the need for glaucoma medication. Studies show it's more successful than medication or laser treatments. While success rates vary, most people achieve good pressure control.

While generally safe, trabeculectomy carries some risks:

Low eye pressure: This is the most common early complication, sometimes causing aching or throbbing. See your doctor immediately if you experience severe blurring, distorted vision, or a shadow in your vision.

Infection: Rare but serious, infection can occur after surgery or even years later. See your doctor right away if your eye becomes red, sticky, or painful.

Bleeding: Serious bleeding is rare.
Cataract: If you haven't had cataract surgery, trabeculectomy may speed up cataract development.

Vision changes: You'll likely need a new glasses prescription after your eye heals.

Trabeculectomy offers long-term eye pressure control for most people. While complications are possible, they are generally rare. Regular follow-up appointments are essential to monitor your eye health and address any issues promptly.