What you need to know about:

Trabeculectomy

Fast Fact

96%

Worth It Rating

Average Cost:

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Recovery Period:

45-60 minutes

Permanence:

Permanent

177

Doctors

Time it takes:

45-60 minutes

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Anesthetize:

Local anesthesia

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Overview of

Trabeculectomy

in Thailand

Trabeculectomy is a surgical procedure in which a small hole is made in the sclera (eye wall) to lower the intraocular pressure (IOP) in the eye in patients with glaucoma. The aqueous humour, which is the fluid inside the eye, drains through this opening into a small reservoir under the eye surface that is hidden by the eyelid. Draining the aqueous humor prevents or slows further damage and further loss of vision in glaucoma. The procedure will not restore vision already lost from glaucoma. In certain complicated cases, the doctor may also place a glaucoma drainage device implant to keep the drainage opening from healing and closing down.

Goals of

Trabeculectomy

A trabeculectomy is a standard surgery for glaucoma that lowers pressure inside the eye when intraocular pressure cannot be managed with eye drops or if the eye drops have side effects that impact quality of life or if the patient experiences an allergic reaction to the eye drops, surgery may be the best option to prevent the condition from worsening.

Price of

Trabeculectomy

Average Cost

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Price Range

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Pros and cons of

Trabeculectomy

Pros

-Success rates are as high as 80 to 90 percent, and when it's successful, it's the best at controlling intraocular pressure. In addition, it allows you more control over the outflow than other current surgical alternatives.

Cons

-The use of anti-metabolites (primarily mitomycin-C) to mitigate healing has enhanced the success rate, while simultaneously opening the door to complications such as bleb leaks, long-standing hypotony, blebitis and endophthalmitis.

-In the glaucomas associated with inflammation or neovascularization, trabeculectomy may not be a good first-line procedure because eyes with inflammation or a neovascular process have increased scar formation. In those situations, an aqueous tube shunt may be a better primary surgery.

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How it works:

Trabeculectomy

You may receive mitomycin C. This is a drug originally developed to treat cancer, but it is now used after glaucoma surgery to reduce scarring. By preventing scarring around the bleb, your eye will be able to drain better, so you have healthier fluid pressure. Mitomycin C will only be applied during the surgery and then washed off with sterile water. You will not be responsible for applying it or removing it. You can undergo this operation with either local anesthesia or under general anesthesia. If you choose to have general anesthesia, you will need to have an overall physical assessment with a physician to ensure your health. Many people do undergo this surgery with only local anesthesia and light sedation. Either way, once the procedure is complete, you will be sent home the same day. Trabeculectomies typically take between 45 and 60 minutes.

Preparation before

Trabeculectomy

Pre - treatment

You will be given specific instructions on how to prepare for the procedure as well as what time and where you should go on the day of the procedure. Please wash your hair and face before you arrive at the hospital on the morning of the procedure. Please let the doctor know of all medication you are taking, especially those with blood-thinning properties, as some may need to be stopped before the procedure. If you are using eye drops to lower intraocular pressure, please continue using them as normal. If general anesthesia is used, you may have to avoid food and water for at least 6 hours before the procedure.

Recovery after

Trabeculectomy

Post - treatment

Please avoid letting the affected eye come into contact with water. Please do not rub your eye or use any other object to do so. Please do not remove the eye covering after the procedure. Please use the prescribed drops and wait 5 minutes between administering drops if they need to be done at the same time. Please be careful not to impact the affected eye. Please keep all follow-up appointments. It is recommended that you wear sunglasses when you are outside. If you experience any abnormal symptoms, such as pain, severe redness, or worsening vision, please see your doctor immediately.

Risks & side effects

While trabeculectomy is considered a safe and effective procedure, there are some risks involved.

These include:

-Post operative Infection

-Increased intraocular pressure

-Lowered intraocular pressure

-Drooping eyelid

-Double vision

-Swelling

-Bleeding

-Developing a hole near the operation site

-Scarring

FAQs:

Trabeculectomy

What are the travel recommendations?

Before the Procedure Please plan to stay in Thailand for at least 2 weeks through the duration of the treatment. It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure. After the Procedure Your eye(s) will be covered for 1 day after the procedure so a family member or friend should come to the hospital with you and accompany you home. Your vision will be reduced in the first month after the procedure. Your doctor will assess your symptoms the day after the procedure. If necessary, you will see your doctor more often than that, depending on their recommendation. If your post-operative intraocular pressure is stable and the new drainage tract functions well and you have no abnormal symptoms, you can return to your home country.

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What is the likelihood of success?

Most procedures to treat glaucoma can only keep the condition from worsening. It cannot reverse any loss of vision. Invasive surgeries like trabeculectomy are reserved as a second line of treatment unless you have acute glaucoma threatening your vision. If eye drops or laser procedures do not work well enough to reduce the fluid pressure in your eye, your ophthalmologist will evaluate you to determine if trabeculectomy is the right procedure for your eye health. Long-term studies show that, if needed, trabeculectomy is a fantastic treatment for glaucoma that often removes the need for prescription eye drops, which can be expensive. Although this is a more invasive operation, medical studies show that it is often more successful at keeping intraocular pressure low than both medication and laser operations.

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When can I get back to work or resume my normal daily activities?

You will need to remain at least 2 weeks off work. Your return to work will depend on a number of factors such as the nature of your job, and the level of vision in the other eye.

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Will there be any vision changes after surgery?

It is expected that after the operation your vision may decrease for a few weeks. It should gradually come back to the same level as before the surgery. Sometimes you may need to change your glasses when your vision becomes stable. Please note that trabeculectomy will not improve your vision or restore any field of vision you have already lost due to glaucoma.

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