Did you know about an eye condition that can lead to blindness if left untreated? Glaucoma, an ocular condition, causes harm to the optic nerve, the link between the eye and the brain. It is a progressive and permanent damage of the optic nerve that arises due to high pressure in the eye. This eye pressure can be reduced by the use of medications or laser therapy. However, in cases when these measures fail to adequately control pressure, one needs to opt for trabeculectomy surgery. We spoke to our expert Dr Digvijay Singh, Director, Noble Eye Care, Gurugram, who explained this surgery, its process, and if it is a major surgery for glaucoma.
When Is Trabeculectomy Surgery Performed?
“The eye can be likened to a balloon containing a unique fluid known as aqueous humour, which is continuously produced and drained, maintaining a balanced flow. While many medications aim to decrease aqueous production, some facilitate drainage”, said Dr Singh. However, if the eye's sieve-like drainage system, known as the trabecular meshwork, becomes obstructed, surgical intervention, known as trabeculectomy, is required to restore its function.
Also Read: Eye Drops Or Laser Surgery? Expert Explains Which Is A Better Treatment For Glaucoma
How Is Trabeculectomy Performed?
Dr Singh explained, “During this procedure, a tiny aperture is created within the eye, and a flap of ocular tissue is manipulated to establish a valve-like mechanism. This mechanism allows fluid to exit if intraocular pressure rises, maintaining optimal pressure levels. Since this hole tends to close, special chemicals are applied to reduce the healing process.”
Trabeculectomy is one of the earliest glaucoma surgical procedures and is widely regarded as the most efficacious, serving as the gold standard in treatment. Its applicability spans across different age groups, from children to the elderly, with ample long-term follow-up data available. Over time, it has been observed that a well-done trabeculectomy surgery is a safe option for glaucoma.
According to Johns Hopkins Medicine, trabeculectomy offers a viable treatment option for various forms of glaucoma, including closed-angle and open-angle, as well as primary and secondary types.
Is Trabeculectomy A Major Surgery?
“The answer is yes. It is an invasive surgery in the eye with the potential for more complications than cataract surgery and a need for constant follow-up. If done well, it serves its purpose and lasts a long time”, highlighted Dr Singh.
Also Read: Diagnosed With Glaucoma? Expert Lists Precautions You Should Take To Preserve Your Vision
Should One Be Afraid Of A Trabeculectomy?
No, one should not be afraid of this surgery. Doctors recommend this surgery only when there is a need to control eye pressure and medicines are unable to do that. If not done at that point, there can be permanent vision loss. Therefore, a patient should not delay the procedure due to fear. Trabeculectomy requires a long-term follow-up and is not a surgery that can just be done and forgotten.
During the initial two months following trabeculectomy, frequent visits to your doctor are essential, often scheduled every one or two weeks. Your doctor may need to adjust the surgical flap to enhance fluid drainage from the eye, a procedure performed painlessly by removing temporary stitches using laser or forceps, as stated in Johns Hopkins Medicine.
Bottomline
Dr Singh concluded, “In the recent past, more forms of glaucoma surgeries have come into practice. These include minimally invasive surgeries, such as stents, goniotomy and trabeculotomy and more invasive ones, such as glaucoma drainage devices (valves). With a wide array of surgical options available, glaucoma specialists can effectively manage the condition. Consequently, there is no reason to fear invasive procedures in the modern era when it comes to preventing this sight-threatening disease.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you notice any complications to get the necessary treatment.]