Procedures
Glaucoma Consultants provides a comprehensive array of surgeries, treatments and procedures for both glaucoma and cataracts. To find out more details on any of these procedures, click on the links below.

SURGERIES:
• Tribeculectomy

The procedure:
Once the decision is made to proceed with a glaucoma filtration procedure, the surgery is scheduled. The procedure is completed in the operating room usually under local anesthesia. On the day of the surgery, one should expect to have several eye drop medications applied multiple times to the eye for approximately on hour prior to the procedure.

The goal of the glaucoma filtration procedure is to create a new passageway by which aqueous fluid inside the eye can escape, thereby lowering the pressure. The escape route, however, is not directly to the external surface of the eye, as this would obviously allow access for bacteria inside the eye and thus, potential infection. The filter therefore, allows the drainage of fluid from inside the anterior chamber if the eye to a "pocket" created between the conjunctiva, which is the outermost covering of the eye, and the sclera, which is the underlying white anatomical structure of the eye. This pocket is referred to as the bleb. The fluid in the bleb is eventually absorbed by blood vessels.

In many cases, medication to control scarring, and thus to help prevent closure of the filtration site, is applied to the eye during operation or just afterwards. These medications, known as Mitomycin C and 5-Fluorouracil (5-FU), will be used in some cases and not others, depending on both surgeon and patient variables.

After your operation:
In most cases, a patch and shield will be placed over your eye on the day of the surgery. This is usually removed later that day or the day after the surgery and eye drops are begun. Your surgeon will usually want to evaluate your eye on the day of the surgery or on the first post-operative day. At that time, depending on pressure in the eye, your surgeon might elect to cut sutures on the flap of the filter to modulate the filtration process. This is often done with a laser while in the office. Antibiotic and anti-inflammatory eye drop medications are continued after surgery for up to 6 weeks or more.

The number of visits to your doctor after surgery may vary widely depending on circumstances. In general, follow-up visits after filtration procedures are quite frequent, as often as every day or two shortly after surgery, with office visits decreasing in frequency as healing progresses.

See our Frequently Asked Questions

Can glaucoma be cured with filtration surgery?
In general, glaucoma is rarely cured, but the progression of the disease may be greatly delayed with surgery, medicine, or laser procedures. If your surgeon has recommended a glaucoma filtration procedure, it is quite likely that your glaucoma is moderately or severely advanced. The goal of this procedure is to preserve your vision. This is usually, but not always, possible.

Does surgery eliminate the needs for medication?
You will certainly need medication after surgery, perhaps for the first 4 to 10 weeks. After the filter site of your eye has entirely healed, whether you will need glaucoma medication will depend largely on the pressure in your eye as well as your peripheral vision (based on a visual field test). In most cases, dependence on glaucoma medication is reduced and in some cases, glaucoma medications are no longer required. Your eye surgeon will determine whether medicines are appropriate based on your final outcome with surgery.

Is there still pressure in the eye after surgery?
Yes. However, after a glaucoma filtration procedure, the pressure may be too low or too high, depending on the degree of filtration. Your surgeon will use many techniques as well as medicines to modulate this effect after surgery. Once healing is complete, usually 6 to 8 weeks after surgery, a new "baseline" pressure is usually established based on the degree of filtration created by the combination of the surgery and subsequent healing.

Does a filter procedure have risks?
All surgical procedures have risks. Glaucoma surgery is no different. The primary risks include, but are not limited to, infection, bleeding, swelling in the retina, development of fluid under the retina (choroidal detachment), retinal detachment, droopy eyelid, double vision, loss of vision, and even loss of the eye. The likelihood of the risks is quite low, but you should discuss the risks, as well as the benefits of the procedure, with your surgeon. In general, if your eye surgeon recommends a glaucoma filter procedure for you, he or she believes that the potential benefits of the procedure far outweigh the risks.

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