Put a stop to glaucoma with filtration surgery in Harrisburg
Learn how this treatment can save your sight if you don’t respond well to medication or laser treatment
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Filtration surgery enables patients to stop lifelong medication
Discover how this highly successful treatment can improve your quality of life
Filtration surgery (Trabeculectomy)
Filtration surgery, also called trabeculectomy, is a treatment for several types of glaucoma including open-angle and narrow-angle glaucoma. We often suggest this treatment to patients who have not responded well to medication or laser treatment such as ALT or SLT. Filtration surgery usually provides a dramatic reduction in pressure within the eye.
Filtration surgery is for those:
- Who have been diagnosed with glaucoma
- Whose doctor has determined that filtration surgery is an appropriate treatment for their condition
What to expect on surgery day
You will need to arrive at the surgery center 30-60 minutes prior to your procedure. Once the team has checked you in, the nurse will prepare you for surgery. They will clean the area around your eyes, apply a sterile drape, give you a sedative to help you relax and numb your eye with local anesthesia. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking.
Using advanced microsurgical techniques and equipment, your doctor will create a tiny new channel between the inside of your eye and the outside of your eye. They will then remove a small section of tissue creating a channel, to allow fluid to pass through the blocked drainage network onto the white (sclera) of the eye. The incision will be closed with small stitches and covered with the thin outer tissue of the eye, called the conjunctiva. Blood vessels in the conjunctiva will carry the draining fluid away.
To keep the drainage channel open, your doctor may apply an extremely small dose of a chemotherapeutic agent to the new filter. The doctor will check your eye pressure shortly after your procedure and may prescribe drops to alleviate any soreness or swelling inside the eye. You should go home and relax for the rest of the day. Most patients resume normal activities within a few days.
Follow-up visits are necessary to monitor your eye pressure. It may take a few weeks to see the full pressure-lowering effect of this procedure, and adjustments may need to be made to the filter during this period. These adjustments may include:
- An injection of small amounts of chemotherapeutic agents
- Loosening or removal of one or more stitches
- Finger pressure to the eye to force fluid through the filter
- Numbing the eye and opening the channel slightly with a fine instrument
- Placing a contact lens over the eye
Advantages
- Long-term, trabeculectomy has been proven to have a high success rate. It’s estimated that 90% of surgeries are successful, with two-thirds of individuals no longer needing medication to control the condition afterwards.
- The decision to intervene with trabeculectomy surgery depends on the stage and progression of the disease. The treatment enables one to limit the progression of glaucoma and allows patients to improve their quality of life, by suspending the drug therapy with eye drops.
Disadvantages
On the other hand, the most common complication that occurs after trabeculectomy is scarring of the opening, which interferes with normal function and prevents proper fluid drainage from the eye.
Other complications that may occur after surgery include:
- Bleeding in the eye
- Infection in the eye
- Blurred vision
- Sudden, permanent loss of central vision
- High pressure in the eye that leads to malignant glaucoma
While trabeculectomy is considered a safe and effective procedure, there are some risks involved. These include:
- Postoperative infection
- Drooping eyelid
- Double vision
- Swelling
- Bleeding
- Developing a hole near the operation site
- Scarring
- Low IOP (hypotony)
In severe cases, some people experience:
- Haemorrhaging inside the affected eye
- Choroidal detachment
- Vision loss
- Very rarely, loss of the eye itself
Step two: We’ll then cover you in a drape that exposes nothing but your eye. During the procedure, you’ll know the surgeon is operating, but you won’t be able to feel anything.
Step three: Your surgeon will create a discrete drainage site beneath your eyelid so that it won’t be visible after the procedure.
Step four: Once we have created the new drainage site, the surgeon will place sutures near the site that hold the drainage site open so that it doesn’t reseal during the healing process. Your stitches will not dissolve and will need to be removed by your doctor within about two weeks.
Step five: Surgery should last between 45 and 60 minutes. After the procedure, we will patch and shield your eye until your follow-up appointment with your surgeon the next day.
Serious complications with filtration surgery are extremely rare, but like any surgical procedure, it does have some risks. Going to a specialist experienced in filtration surgery can significantly minimize the risks.
If you and your doctor decide that filtration surgery is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.
- If you would like more information about this procedure, you can make an appointment or contact the office for additional information.
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Academic resources on flashes and floaters
FOLLOW THE LINKS BELOW TO DISCOVER MORE ABOUT THIS TREATMENT FROM AUTHORITATIVE SOURCES
Dots and lines (floaters) or flashes of light in your vision are common. They’re not usually serious. Click here to read on.
Floaters look like small specks, dots, circles, lines or cobwebs in your field of vision. While they seem to be in front of your eye, they are floating inside. Floaters are tiny clumps of gel or cells inside the vitreous that fills your eye. What you see are the shadows these clumps cast on your retina. Click here to read on.
When we are young, the gel inside your eye (the vitreous) is firmly attached to the back of your eye. As we get older, the vitreous gel naturally becomes more liquid and collapses away from the retina. This is called posterior vitreous detachment (PVD). Click here to read on.
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CHOOSE THE MOST EXPERIENCED CATARACT AND LASIK SPECIALISTS IN CENTRAL PENNSYLVANIA
Dr. Bennett Chotiner
M.D., F.A.C.S.
MEDICAL DIRECTOR, LASIK SURGERY, CATARACT SURGERY, GENERAL AND PAEDIATRIC OPHTHALMOLOGIST
Dr. Bennett Chotiner is the founder and medical director of Memorial Eye Institute. A noted innovator, in 1977 he established his clinical practice, the Pennsylvania Eye Associates. In 1984, he established the Pennsylvania Eye Surgery Center, Pennsylvania’s first …
Dr. Erik A Chotiner
M.D., F.A.C.S.
GENERAL OPHTHALMOLOGY, CATARACT & REFRACTIVE SURGERY, LASIK SURGERY
Erik Chotiner, M.D. diagnoses and treats a wide range of medical eye conditions. He is a Phi Beta Kappa graduate of Franklin and Marshall College. Dr. Chotiner attended Jefferson Medical College in Philadelphia where he received multiple awards including the Physiology Prize for …
