Trabeculectomy is a filtering glaucoma surgery that creates a new drainage channel for aqueous humour from the front of the eye to a reservoir (bleb) under the conjunctiva. It is performed to achieve low intraocular pressures when other treatments are insufficient.
Surgical Steps
The surgeon fashions a partial‑thickness scleral flap and opens a small window into the anterior chamber so fluid can percolate into the subconjunctival space. Antiscarring medication may be applied to help keep the new pathway open.
- The bleb is usually located under the upper eyelid and may be visible as a small blister
- Fine sutures regulate flow and can be adjusted or released after surgery
- Trabeculectomy can be combined with cataract surgery in selected cases
- Intensive post‑operative drop regimens and frequent visits are essential
Effectiveness and Risks
Trabeculectomy is highly effective at lowering pressure but carries risks such as infection, very low pressure, bleb leaks, and fluctuating vision. Careful follow‑up and patient education are vital.
- Procedures like needling may be needed to revive a failing bleb
- Patients must recognise symptoms of late bleb infection and seek urgent care
- Despite its demands, trabeculectomy remains a gold-standard option for advanced glaucoma
- Success depends on surgical technique, healing response, and adherence to aftercare
