Definition:
- Filtration surgery or trabeculectomy is a common surgery performed to treat the open-angle glaucoma. Glaucoma is a group of diseases affecting the optic nerve and if not treated in time, it can cause blindness.
- Glaucoma mostly characterized by increased intraocular pressure (IOP) of the eye. The surgery is performed to prevent further loss of vision by lowering intraocular pressure. Surgery can not improve or reverse vision loss.
Why it is needed:
The filtration surgery is usually performed to treat glaucoma when the medication fails to reduce the IOP and prevent further damages to optic nerve. It is important to know that usually there are no symptoms and signs of glaucoma in its early stage. The symptoms that are found in later stages includes:
- Loss of peripheral side vision
- Headache
- Difficulty or inability to adjust vision in darkened rooms and focusing on close works
- Halos or rainbow coloured rings around lights
However, the eye has already been severely and irreversibly damaged at the point when any of these symptoms occur.
Facts and Figures:
- Glaucoma is the second leading cause of blindness (W.H.O), approximately 10% of people with glaucoma experiences loss of vision, even after receiving proper treatment for same.
- The disease is estimated to affect 1-2% of the US population and an estimated 67 million people worldwide
- There is no cure for glaucoma up till now, only early diagnosis helps to preserve the vision
- It is estimated that about 2% of the population ages 40-50 and 8% over 70years of age have elevated IOP
Advantages and Disadvantages:
Advantages
- Filtration surgery prevents the visual loss by reducing IOP in the eye.
- It helps to maintain useful vision and to avoid further damages to optic nerve
- The procedure is done at an out-patient ward and usually takes less than an hour
- Medical tourist can go back to home within 3-4 days after the procedures
Disadvantages
- There are chances that optimum result may not obtain from the first surgery and second Filtration surgery needs to be performed or medications needs to be continued to reduce the IOP
- Filtration surgery may not give desired result or not advised in conditions like:
- Congenital glaucoma
- Diabetics with glaucoma
- Patient with past history of eye surgery
Risks and Complications:
- Scarring of the opening
- Severe blurring
- Bleeding in the eye
- Low eye pressure
- Cataract
- Loss of vision
- Infection
- Droopy eyelid
Pre-operative and Post-operative care:
Pre-operative preparation
- Full eye examination by ophthalmologist
- Inform surgeon regarding previous eye surgery or any treatment related to eye disease and have a list of medicine that had to be stopped or to be taken before surgery
- Inform him about any allergies and habits of smoking or alcohol
- Put eye drops regularly 2days before surgery or as prescribed by the doctor
- Arrangement for leave from work, help at home, helps with driving and post surgery care
- Medical tourist are advised to select a comfortable and handicap accessible hotel room, for recovery after getting discharge from hospital
Post-operative care:
- It is necessary to follow the post operative instructions carefully, as the success of the surgery greatly depends on the rate and extent of conjunctival healing.
- The eye of the patient will be taped shut after the procedure and a protective covering is placed over the eye. Patients need to wear the bandages for 24 hours after the procedure
Do’s, Don’ts and Precautions:
- Do take prescribed medicines regularly
- Do wear eye shield while sleeping for 1 month
- Don’t perform any vigorous activity involving straining and lifting for 8 weeks
- Patient can resume light activity within 48 hours of the procedure
- Avoid hot tubs or pools
- Avoid eye make up for 1-2 weeks
- If possible do not sneeze or cough forcefully
