Trabeculectomy

A common and effective surgery for open-angle glaucoma

Trabeculectomy is a widely performed traditional surgery specifically designed for the treatment of open-angle glaucoma. In this procedure, the surgeon creates a small flap in the sclera (the white part of the eye) and establishes a tiny reservoir or drainage hole underneath the upper eyelid. This technique enables excess fluid to drain from the eye, significantly lowering intraocular pressure and helping to preserve vision.

Due to the nature of Trabeculectomy, close monitoring after the surgery is crucial. Therefore, this procedure should be carried out in a specialist eye unit to ensure optimal care and outcomes.

If you're seeking an effective solution for managing open-angle glaucoma, Trabeculectomy may be a suitable option to discuss with your eye care specialist.

Who is a Candidate?

Patients with glaucoma (most often open-angle glaucoma) in whom intraocular pressure (IOP) cannot be controlled adequately with:

• Maximum tolerated medical therapy (eye drops or oral medication), and/or
• Laser procedures (e.g. laser trabeculoplasty).

May also be indicated in secondary glaucomas where pressure remains uncontrolled.

Sometimes used earlier in disease for rapidly progressing optic nerve damage.

Recovery Timeline

This is likely to vary with provider.

• Hospital stay: Usually day surgery or overnight observation
• Initial recovery: Vision may be blurry for 1–2 weeks
• Return to normal activities: 4–6 weeks (depending on healing and IOP stability).

Frequent postoperative check-ups are essential (especially in the first 6–8 weeks) to monitor bleb function and prevent scarring.

Full healing and IOP stabilisation typically occur within 2–3 months.

Benefits

• Lowers intraocular pressure (IOP) effectively by creating a new drainage pathway for aqueous humor
• Helps preserve remaining vision and slow or stop glaucoma progression
• Can reduce or eliminate the need for glaucoma medications.

Risks

• Early complications:
  
  • Bleeding, infection, excessive drainage leading to very low eye pressure
  • Shallow anterior chamber or choroidal detachment
• Late complications:
  
  • Scarring or failure of the drainage leading to a rise in IOP
  • Rarely, endophthalmitis (severe eye infection)
• Vision fluctuations or blurred vision during recovery.

This is just an outline. Your specialist eye surgeon will be able to talk to you about these issues in more detail and make sure that there is informed consent.

Trabeculectomy remains the gold standard surgical treatment for glaucoma when medical or laser therapy fails — but success heavily depends on postoperative care, as scarring or infection can compromise the outcome.