Surgical treatment must be considered when medical therapy
has failed to prevent loss of vision. In some patients, loss of vision
on the initial examination is so advanced that surgical intervention
must be considered before medical therapy.
Trabeculectomy
is the most common surgical procedure for glaucoma. It is usually
performed in an operating room on an out-patient basis. Anesthesia is
by local injection, similar to cataract surgery. The procedure usually
lasts for one hour and is pain-free.
During the
surgery, a small opening is created through the wall of the eye where
the sclera, or white of the eye, meets to iris, or color of the eye.
Fluid from the eye can now leak out of the eye, not into the tears, but
into the tissue surrounding the eye. A small cyst or bleb forms on the
outside of the eye.
Following surgery, a patch and
shield are worn for one day. Vision may be blurred for one to three
weeks after surgery. Activities such as driving the car, reading, and
walking may be resumed in two to three days after surgery. Physical
activities such as bending and lifting are avoided for one to two
weeks. There are no changes in diet.
Trabeculectomy
successfully lowers the pressure in the eye in about 80% of patients.
In 20%, the pressure elevates again and further therapy or repeat
surgery is necessary. Complications include bleeding in the eye,
infection, and the need for additional surgery.
All
trabeculectomy surgery through the Glaucoma Center is performed through
the Ambulatory Surgery Center of University Hospital at Stony Brook. No
other center in Suffolk County performs as many trabeculectomy
procedures as done here.
