Glaucoma

Trabeculectomy

Dr Skalicky is a highly experienced glaucoma surgeon

 

Trabeculectomy is a suitable procedure for lowering intraocular pressure of the eye when less invasive medical treatments such as eye drops and laser surgery have been unsuccessful. Glaucoma is typically caused by an elevated pressure inside the eye damaging the optic nerve that links the eyes to the brain.

17. Trabeculectomy

Trabeculectomy

In Trabeculectomy surgery, a small channel is made to drain fluid from the eye into a reservoir located underneath the eye’s natural lining, the conjunctiva. This reservoir, known as a bleb, may appear like a blister-like bump on the white of the eye. The bleb is not usually visible as it is covered by the upper eyelid. Anti-scarring drugs (5-fluorouracil or Mitomycin C) may be used to improve the success of the operation.

A Trabeculectomy is usually carried out under a local anaesthetic.

The aim of the operation is to reduce the risk of further damage to the optic nerve by lowering the eye pressure. It will not improve your sight, but will hopefully help protect your vision in the long term.

Compared to other treatments, surgery provides the most definitive long-term eye pressure control.

If untreated, pressure-related damage to the optic nerve can lead to permanent loss of vision.

 

Prior to Trabeculectomy Surgery

On the day of surgery, you will arrive at the hospital fasted. If necessary you can take medications with a small sip of water.
If, however you are on blood thinning agents (eg warfarin, pradaxa, aspirin or clopidogrel) these probably need to be ceased before surgery. Please discuss this with our surgical booking team.  They can be restarted the day following the surgery.

Prior to the operation, you will be met by hospital staff and by the anaesthetist. The anaesthetist will then insert an IV cannula and provided intravenous sedation to relax and block pain. Then a local anaesthetic is injected in and around the eye to temporarily immobilise and numb the eye.

 

During Trabeculectomy Surgery

In theatre a sterile cover will be placed over your face to keep the area clean – you will be able to breath easily under this. It is important to keep still, but please let us know if you feel you need to cough or sneeze, or are in discomfort.

You do not need to worry about keeping the eye open during surgery – we will do this for you.

Post Trabeculectomy Surgery

You will be unable to drive immediately after your surgery, so you should arrange your own transport on the day of the surgery and the clinic appointment one day afterwards. You will be seen regularly over the next few weeks by Dr Skalicky. You may receive further anti-scarring injections around the eye and/or adjustment of the sutures. This is important to give the surgery the best chance of success.

Short term side effects between 2-6 weeks post-surgery include:

  • Watery eyes
  • Gritty sensation in the eye
  • Redness
  • Blurred vision
  • Sometimes the surgery can slightly alter the power of your eye focus, requiring a change in glasses.

Post-operative care:

  • Pain relief: paracetamol or panadeine.
  • Eye shield over the eye at night in bed for 5 nights
  • Cessation of all your regular glaucoma medications in the operated eye.
  • You will commence two drops – one antibiotic (one drop 4 times daily for 1 week) and one anti-inflammatory (one drop every hour). The anti-inflammatory drop is important to prevent scarring of the drainage pathway and must be used as frequently as directed. The frequency will be reduced over the next few weeks, but you will need these drops for a total of 4-6 months.

Why choose Dr Skalicky for your Trabeculectomy

Glaucoma surgery is technically demanding, and precision work and care is required during and following the operation. Dr Skalicky is an impeccably trained glaucoma surgeon, able to deliver all forms of glaucoma surgery with excellence. His gentle and warm care combined with a meticulous surgical approach ensures optimal results. He diligently follows his patients following surgery and communicates well with them and their family throughout the process.

Accreditations & Credentials

Dr Skalicky is an active clinician, surgeon, researcher, teacher, academic and health advocate who has published over 40 articles in international Ophthalmology journals. Known as an Ophthalmologist ahead of the times, Dr Skalicky’s career highlights are exceptional and atypical for his age.