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Filtration Surgery 2020-12-10T00:31:24-05:00

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
Depending on the severity of your glaucoma, minimally invasive glaucoma surgery (MIGS) could be an alternative treatment.
Step one: We will clean and numb your eye and fit a lid speculum to hold it open.

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.

The success rate for this type of surgery is approximately 80% in cases where no surgery has been done on the eye before. However, everyone’s eyes are unique, and many people do require further treatments. In more difficult cases where even filtration surgery doesn’t prevent damage to the ocular nerve, it may be necessary to perform other types of procedures.

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.

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Give us a call on (717) 657-2020 or book an appointment online. Our warm and friendly team are here to guide you every step of the way.

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Visit our office in Harrisburg for an assessment that will give you a complete understanding of your treatment options.

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My eyes feel dry, gritty and irritated

Whether you’re working on your laptop, driving to the shops or simply catching up with friends, dry eyes can be not only painful and a nuisance but can lead to more serious eye damage long term. Click here to learn more and protect your eyes…

I’ve been diagnosed with a worrying eye condition

If you’ve recently been diagnosed with a worrying eye condition like open angle glaucoma, narrow angle glaucoma, diabetic retinopathy or macular degeneration then you’ll want to see an expert as soon as possible. Click here to learn more about your eye condition and then book an appointment.

Mine (or my child’s) eyes are pink, uncomfortable or crossed

Red, inflamed or gunky eyes can indicate an infection. Click here to relieve your eyes.

Another common concern we see mostly in children is strabismus (also called crossed eyes). Click here to find out why you need to address your child’s crossed or lazy eyes as soon as possible.

“I had no idea it would make such a huge difference to my life”

Thousands of happy patients in Central PA

we help PEOPLE IN AND AROUND THE HARRISBURG COMMUNITY LIVE IT UP WITH BETTER VISION

My wait time was minimal and I was pleased to note the furniture arrangement for social distancing and the sanitation practices in progress. All in all it was a much more relaxing experience than I anticipated and I was impressed by the procedures taken to assure safe practices for the safety of the patients and staff while reducing stress on the patients.

C.J.S.

The doctor and his staff made my cataract surgeries a ‘piece of cake’. I have been coming here since I moved to Harrisburg 37 years ago. Dr. Chotiner performed cataract six years ago and my sight is as good as it was when I was young. As long as the light is reasonable, I do not even need over the counter reading glasses.

Claire B.

I was well taken care of. They took good care of my things. Dr. Erik Chotiner did an excellent job. I am so happy to see quite clearly with my eye that has macular degeneration.

S.D.H.

Very happy with all the staff, from check in, check out and nursing in pre op. Amazing. Very clean facility. Dr. Chotiner is so efficient and fast. Would recommend him to everyone.

Vey L.

Excellent care and personal attention are provided at Memorial Eye. Hats off to Dr. E. Chotiner, nurses and staff for making my experience there so great!

Q. B.

I had cataract surgery and correction of an astigmatism. In one word……excellent!

Ray J.

As a rookie having my first visit at Memorial Eye in May 2020, I asked for a doctor that was patient and that is exactly what I got in Dr. Kowalski. He took his time and explained my options to me. My testing was extensive and thorough. The staff was very kind and made me feel relaxed during the surgery. A 5 star rating from beginning to end. Well done!

J.E.R.

I am a first time patient at your practice. Everyone was so nice and knowledgeable. Overall it was a great experience. I did not realize how bad my vision was. I am amazed! The get well flowers were a nice touch!

J.B.

The staff and doctor were very accommodating. Always on time, if not earlier with appointments. The surgical staff was very attentive to any needs such as extra blankets if needed, and making sure you were comfortable while you waited for your surgery.

Pam C

First time in 78 years I can see well without prescription lenses! I was apprehensive to have any elective surgery during the pandemic with my age and health history. The staff sensed it and made an effort to deal with it very professionally.

W.H.R.

Wonderful practice with kind and supportive employees. The doctors are top notch and excellent!

A. Hendrix

I had my surgery done for a cataract and to correct my astigmatism. I can see better out of the eye that Dr Chotiner performed surgery on without the need for a corrective lens than I can see out of the other eye with my glasses on. The surgery was delayed because of the whole Covid virus closings, but when it was performed it went incredibly well and I could not be happier with the results.

Robin

I was somewhat jittery about returning to the office after the COVID restrictions were lifted. My concerns were put to rest from the moment I stepped through the door and was greeted by an associate who took my temperature, asked pertinent questions, and offered hand sanitizer, as well as being very friendly. The check in and co-pay payment went equally as smoothly.

C.J.S.

My care for cataract removal was superb. The team in the surgical suite was very organized, efficient, and caring. Their expertise was so excellent. Everyone who works there was very skillful in their work and courteous. Dr. Chotiner is kind and extremely skilled. He was outstanding!

M.V.

Surgery was quick and easy. Staff was very pleasant. Would recommend Dr. Chotiner very highly.

Patricia Scheidler

Service is very complete and professional. Dr. Erik Chotiner was very friendly and able to answer all of my questions. I am very pleased with service and will recommend.

A. Lawrence

I am so glad the doctor suggested LRI with my cataract surgery. I had never heard of it but it is amazing how my astigmatism is dissipating slowly and it is the reason I started wearing glasses 30 years ago! Even working around pandemic guidelines everyone is polite and cooperates as a team.

A.A.N.

I would recommend Memorial Eye Institute and Dr. Erik Chotiner for their expertise. They are all very professional and caring for their patients. It was an excellent experience.

Joyce K.

I cannot thank Dr. Chotiner and his staff enough for what they have done for me. I had LASIK here 16 years ago and that was a life changing event for me. Prior to that, my vision was always poor and then (after surgery) it was great. Now I have cataracts and once again, getting the first eye done was a life changing experience.

Richard B.

I was very pleased with the efficiency and professionalism of the staff. You have a well oiled team. Everyone is very thorough. Thanks Dr. Rick and staff.

M.A.B.

I am so happy at how good I can see now. Everyone was very professional and efficient. I feel my Dr is one of the best. I wouldn’t go to anyone else. Every one there was just great. Thank you so much.

Glenn C.

We have replaced the images of real patients who provided these testimonials to protect their privacy.

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Watch patient videos about eye surgery

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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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Recognized leaders in Harrisburg eye surgery

CHOOSE THE MOST EXPERIENCED CATARACT AND LASIK SPECIALISTS IN CENTRAL PENNSYLVANIA

Dr. Bennett Chotiner
M.D., F.A.C.S.

MEDICAL DIRECTOR, GENERAL OPHTHALMOLOGY, CATARACT & REFRACTIVE SURGERY, LASIK SURGERY

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 …

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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 …

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Dr. Richard M. Kowalski
Dr. Richard M. KowalskiO.D
Dr. Kowalski is a specialist in comprehensive eye care, refractive surgery consultations and contact lenses…

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Dr. Kenneth H. Levin
Dr. Kenneth H. LevinM.D.
Dr. Levin is a specialist in cataract surgery, glaucoma and general ophthalmology

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Dr. Bradford K. Sgrignoli
Dr. Bradford K. SgrignoliD.O
Dr. Sgrignoli is a specialist in retina and vitreous disease & surgery, macular degeneration and diabetic retinopathy…

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Dr. Michael J. Silvetti
Dr. Michael J. SilvettiO.D
Dr. Silvetti is a specialist in comprehensive eye care, refractive surgery consultations, contact lenses and low vision consultations…

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Dr. Katherine Won
Dr. Katherine WonO.D
Dr. Won is a specialist in comprehensive eye care and contact lenses…

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