Trabeculectomy

Trabeculectomy is a surgical procedure that removes part of the trabeculae in the eye to relieve pressure caused by glaucoma.

The procedure is performed in an operating room, usually under local anesthetic. However, some ophthalmologists give patients only a topical anesthetic. A trabeculectomy involves removing a tiny piece of the eye-ball.

(A). During a trabeculectomy, the patient’s eye is held open with a speculum. The outer layer, or conjunctiva, and the white of the eye, or sclera, are cut open.

(B) A superficial scleral flap is created and a plug of the sclera and the underlying trabecular network is removed.

(C)This allows the fluid in the eye to circulate, relieving pressure. The scleral flap is closed and sutured.

(D) The conjunctiva is closed where the cornea connects to the sclera, to create a flap that allows fluid to escape the anterior chamber without deflating the eye. The area is called the trabecula. After the procedure, fluid can flow out onto the eye’s surface, where it is absorbed by the conjunctiva, the transparent membrane that lines the sclera and the eyelids.

Sometimes, an additional piece is taken from the iris so that anterior chamber fluid can also flow backward into the vitreous.

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