Releasing the Pressure Off Trabeculectomy

I’d like to start by making a confession… Needles and Injections and Surgeries scare the hell out of me. It was the only thing that got me to eat my greens or do my homework. It could make me run like the wind from the doctor’s clinic despite high fever. Heck, I had to shut my eyes when my kids got their shots too!

Now you would know why my husband broke into a cold sweat when I was told that I was to undergo a Trabeculectomy. Me? I was blissfully unaware of what the entire mumbo jumbo was about. A few weeks ago, I had begun having trouble with my vision but did not think much of it as it gave me no pain whatsoever. After my husband’s pestering for a few months, I finally sought out an appointment with an eye doctor. Expecting to come away with a pair of glasses, I was very nonchalant about the whole visit. But soon things seemed to get very serious … Glaucoma … Trabeculectomy … My Google savvy husband and the doctor seemed to be talking an alien language altogether…

It was too much info for me all at once! As soon as I got home, I got a list of questions ready of all the things that I wanted to ask. Here’s that list in the hope that it helps someone out there who is in the same boat as me…

What is Glaucoma?
Glaucoma is an eye disorder which causes damage of the optic nerve. The optic nerve carries visual impulses from our eye to our brain enabling us to see. Glaucoma is generally caused due to increase in the pressure inside our eyes.

What are my options?
Eye drops, Laser and Surgery. Eye drops help decrease the pressure in one’s eye. When medications and laser do not help, Surgery for Glaucoma called Trabeculectomy may be advised by the doctor.

What does Trabeculectomy mean? How will it help my Glaucoma?
Glaucoma occurs because the area draining away fluid from the eye gets blocked, thus raising the eye pressure. In this surgery, a tiny hole is made in the white part of the eye. This new drainage hole allows fluid to flow out of the eye into a bubble like filtering area called a bleb. The bleb is mostly hidden under the eyelid. Thus the procedure lowers eye pressure and reduces the risk of vision loss from glaucoma.

A few questions about the procedure…

How long will the procedure take?
Simple Trabeculectomy takes about 20 to 30 minutes. However it may take longer if combined with another surgery like cataract (around 45 minutes).

What are the risks?
Eye pressure becoming too low, eye pressure not reducing enough, infection in the bubble (bleb), clouding of the lens (cataracts), bleeding, swelling of the clear covering over the coloured part of the eye (corneal edema) or scarring of the opening can sometimes occur.

The Most Important Question of All…

Needles? Will I be asleep? Will it hurt too much?
You will be awake the whole while. Eye drops can be used to benumb your eyes (called topical anaesthesia) but it is prudent to perform the surgery under local anaesthesia where your eye and the area around it is numbed.

What about after the surgery?

Will I need to use medications even after surgery?
Generally it is not required but sometime you may require one or two drops.

What precautions should I take after surgery?
Avoid any injury or contact with water in the operated eye for 1 month. Avoid lifting heavy weights. Use eye drops as prescribed by your doctor by pulling the lower eye lid.

Now for a few unsettling ones…

Will I be able to see 100 % after surgery?
No, unfortunately, you will not be able to see 100% after surgery. Glaucoma is a blinding disease where there is irreversible nerve damage. Surgery is the last resort to control eye pressures which are not getting controlled despite multiple medications. However if a combined surgery like cataract and Trabeculectomy is done then definitely one can regain 10%-20% of the lost vision.

What is the success rate of this surgery?
Success rate is 70%. If a plain Trabeculectomy is performed then the chances of developing cataract after surgery is high. If any of the earlier mentioned complications develop, they may require intervention. Lifelong follow up at regular intervals is required after the surgery.

Curious to know if I ran out of the operating theatre as well? Well, I’ve scheduled my surgery for next week. Fingers crossed…Wish me luck!

Want to rule out Glaucoma? Wish to have an expert's opinion on Glaucoma? Patients from Nerul, Sanpada, Vashi, Airoli, Kharghar and Panvel have already benefitted from Glaucoma Services at Advanced Eye Hospital and Institute. Book an appointment today if you wish to avail the same.

You may also like to read:Glaucoma

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