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KEY POINTS
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Glaucoma is an eye disease that damages the nerve that carries visual messages to the brain (optic nerve). This is usually caused by high pressure inside the eye. Damage to the optic nerve can cause a permanent loss of vision. Glaucoma needs to be diagnosed and treated early to prevent blindness.
Normally, the fluid in the front of the eye (the aqueous humor) is constantly flowing from where it is formed (the ciliary body) to the front of the eye. This fluid nourishes your eye and helps to keep its shape. The area between the iris (colored part of the eye) and the cornea (the clear outer layer on the front of the eye) is called the angle. Fluid drains out through the angle, into drainage channels, and is then reabsorbed by the body. When fluid flows out too slowly, eye pressure builds up.
The two main types of glaucoma surgery are trabeculectomy and tube shunt surgery. Both create small passageways from the inside to the outside of your eye in order to better drain the fluid from your eye. In trabeculectomy, the passageway is made out of the white part of the eye. In tube shunt surgery, a tiny tube is placed in the eye. Both can lower the pressure in your eye and may help prevent more damage to the optic nerve and loss of vision.
Trabeculectomy (also called filtering surgery) or tube shunt surgery may be used when:
Ask your healthcare provider about your choices for treatment and the risks.
The procedure is done in an operating room.
You will be given a sedative to help you relax. Your eye will be numbed with eye drops or a shot of a local anesthetic around the eye so you will not feel pain during the surgery. Some people need general anesthesia. General anesthesia relaxes your muscles and you will be asleep.
After you have been given the anesthetic, your provider will make a small drainage channel so that fluid can flow from inside the eye to outside the eye. The fluid flows through the new opening, under the clear covering over the white part of your eye, and then collects in a tiny pouch, called a bleb, underneath the eyelid. The fluid is then slowly absorbed into the bloodstream. Your provider may put some medicine on the eye to keep the new channel from scarring closed.
You will need to be examined the next day. Your provider may want to check your eyes once or twice a week for 4 to 6 weeks after your surgery.
You will use various eye medicines after surgery to help healing and to reduce the risk of infection.
Your vision may be blurred for several weeks after surgery. You may need medicine after the surgery to help maintain normal eye pressure. Once your eye heals, you may need to get a new eyeglass prescription.
In general, you will not be able to wear contact lenses after trabeculectomy. If you are a contact lens wearer, talk to your eye care provider about your options.
Ask your healthcare provider:
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Every procedure or treatment has risks. Some possible risks of this procedure include:
Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.