Trabeculectomy
Trabeculectomy is a surgery filter for treat glaucoma. Glaucoma is a group of disorders that cause progressive damage to the optic nerve and irreversibly affect vision. Most types of glaucoma are associated with a failure in the aqueous humor drainage system which, in turn, generates an increase in intraocular pressure (IOP).
Almost all types of glaucoma can be treated through a trabeculectomy. This procedure, also known as filtration surgery, it is very safe and effective for treat glaucoma surgically and is performed on an outpatient basis. Glaucoma is a chronic disease, so a patient with this disease may need to undergo trabeculectomy several times.
Trabeculectomy
Trabeculectomy is a surgery filter for treat glaucoma. Glaucoma is a group of disorders that cause progressive damage to the optic nerve and irreversibly affect vision. Most types of glaucoma are associated with a failure in the aqueous humor drainage system which, in turn, generates an increase in intraocular pressure (IOP).
Almost all types of glaucoma can be treated through a trabeculectomy. This procedure, also known as filtration surgery, it is very safe and effective for treat glaucoma surgically and is performed on an outpatient basis. Glaucoma is a chronic disease, so a patient with this disease may need to undergo trabeculectomy several times.
What is trabeculectomy?
El glaucoma It is a consequence of a failure in the aqueous humor drainage system. This fault can commonly be caused by the blockage of the drainage channel or by the narrowness of the iridocorneal angle.
Trabeculectomy is a drainage surgery performed to treat glaucoma surgically. The objective of this intervention is to eliminate the aqueous humor accumulated in the anterior chamber of the eye with the purpose of reduce intraocular pressure.
Trabeculectomy allows filter the aqueous humor outwards through a filter bubble. As the aqueous humor begins to flow, the intraocular pressure decreases, preventing the formation of optic nerve injuries that can compromise vision.
When it's made?
Trabeculectomy is one of the most used treatments to treat glaucoma of open angle, although it can also be used in patients with glaucoma of closed angle.
This filtration surgery is recommended for patients who have high levels of intraocular pressure and do not respond positively to treatment with eye drops or oral drugs. Trabeculectomy is usually a surgery performed on patients with a intermediate or advanced phase glaucoma.
Previous Exams
Before performing a trabeculectomy it is important study in detail the structures of the eye of the patient to determine if this surgery is the ideal technique for operate glaucoma.
The purpose of the preoperative study is to detect what stage the glaucoma is in, determine what damage it has caused to the structures of the eye and rule out other eye pathologies.
The most common tests that are performed before doing the operation are:
- Campimmetry or c testampor visual
- Tonometry to measure intraocular pressure.
- Gonioscopy to study the state of the iridocorneal angle.
- Pachymetry to measure the thickness of the cornea.
- OCT to study the state of health of the optic nerve.
How is the operation?
El process of a trabeculectomy We will divide it into 3 parts:
Before the surgery
Depending on the patient's age, the type of glaucoma they suffer from and the stage of the disease, we can consider combine trabeculectomy with a cataract surgery.
During
During trabeculectomy we create a way out for the aqueous humor by opening a small opening in the sclera, the white part of the eye. Once this step is done, we remove part of the trabecular meshwork in order to create a ampfiltration pot in the conjunctiva of the eye. The function of this amppot is to filter the aqueous humor.
So that the result of the intervention is as expected, it is important that the exact amount of aqueous humor flows outward. In the event that there is an excess of aqueous humor outflow, we will excessively reduce the intraocular pressure of the eye, incurring ocular hypotony. If, on the other hand, it does not drain enough, we will again incur an increase in intraocular pressure.
After
After a trabeculectomy the patient, if not a child, can go home. Usually after surgery we apply antibiotic and cover the eye with an eye protector. The patient should use this protector to sleep.
It is important that the patient Follow medical directions to the letter and apply prescribed corticosteroid medications to fight inflammation. It is important to attend all medical check-ups and avoid any activity or sudden movement that could alter the eye.
Efficacy and results
La ampThe filter pot that is created during the trabeculectomy allows the aqueous humor to flow out and be reabsorbed into the bloodstream. This filtration mechanism is very successful for monitor intraocular pressure levels in the eye, but because glaucoma is a chronic disease that keeps progressing, the patient will likely need another trabeculectomy in the future.
In some cases trabeculectomy is not the first surgical option, this usually occurs in patients African American, cases of congenital glaucoma o neovascular and people diabetics.
Currently, modern surgical techniques in glaucoma surgery have begun to displace trabeculectomy for some indications. Among the most effective when it comes to correcting glaucoma, we should consider, if possible, the non-perforating deep sclerectomy (EPNP) or the minimally invasive glaucoma surgery (MIGS).
Trabeculectomy complications
The most common complication after a trabeculectomy is formation of scar tissue at the opening that prevents the leakage of aqueous humor. If the opening heals the amppressure cooker stops working and the patient may need to be operated on again. Medications are applied during surgery to prevent scarring from occurring, but the risk is always present.
Other complications that can occur after a trabeculectomy are as follows:
- Hemorrhages
- Blurry vision.
- Eye infection.
- Loss of central vision.
- Cataract formation.
