Trabeculectomy: What You Should Know

What is a Trabeculectomy?

A trabecular meshwork (TMW) or tracheostomy is a surgical procedure in which the surgeon removes part of your windpipe through the mouth opening. The TMW allows doctors to perform surgery on airway obstruction without damaging vital organs like the heart, lungs, liver, kidneys or brain. A TMW is usually used to treat chronic obstructive pulmonary disease (COPD), but it may also be used when other treatments have failed.

The operation itself takes less than five minutes and results in little or no pain relief. The patient will experience some shortness of breath during the procedure, but this will go away within a few days.

Why choose a trabeculectomy?

Traditionally, there were two main reasons why people chose to undergo a trabeculectomy: 1) they had difficulty breathing due to COPD; 2) their symptoms did not respond well to other treatments.

Many other surgical procedures have been developed since the trabeculectomy and are now available. These other procedures may be more suited to your particular condition and goals in life. If you are considering a trabeculectomy, it is important to speak with your doctor about the advantages and disadvantages of this procedure, so that you can make an informed decision.

How do you prepare for a trabeculectomy?

To prepare for a TMW, you should talk to your doctor about the exact procedure that will be performed. The specifics of the operation will vary from patient to patient, but there are some common factors.

All medical procedures carry a small risk of infection or bleeding, so your doctor may ask you to use antibiotics and/or anticoagulants for several days before the TMW. You should also tell your doctor about any medications you are currently taking, as these may interfere with the TMW or cause complications.

Once you have received the go-ahead from your doctor, there are a few steps you can take to prepare for the operation.

You will need to stop eating and drinking for several hours before the procedure. This will help prevent vomiting and choking during the operation, as well as making it easier for doctors to examine your throat and windpipe.

Sources & references used in this article:

Use of the megasoft bandage lens for treatment of complications after trabeculectomy by MDW Blok, JHC Kok, C van Mil, EL Greve… – American journal of …, 1990 – Elsevier

Long-term results of trabeculectomy in eyes that were initially successful. by JT Wilensky, TC Chen – Transactions of the American …, 1996 – ncbi.nlm.nih.gov

Australia and New Zealand survey of antimetabolite and steroid use in trabeculectomy surgery by L Liu, D Siriwardena, PT Khaw – Journal of glaucoma, 2008 – journals.lww.com

Trabectome (trabeculectomy—internal approach): additional experience and extended follow-up by D Minckler, S Mosaed, L Dustin, B Francis… – Transactions of the …, 2008 – ncbi.nlm.nih.gov

Outcomes of combined cataract extraction, lens implantation, and trabeculectomy surgeries by EJ Rockwood, B Larive, J Hahn – American journal of ophthalmology, 2000 – Elsevier

Trabeculectomy versus EX-PRESS shunt versus Ahmed valve implant: short-term effects on corneal endothelial cells by G Casini, P Loiudice, M Pellegrini, AT Sframeli… – American journal of …, 2015 – Elsevier

Glaucoma surgery (trabeculectomy) by H Australia – 2019 – healthdirect.gov.au