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Tube-shunt surgery (seton glaucoma surgery) involves placing a flexible plastic tube with an attached silicone drainage pouch in the eye to help drain fluid (aqueous humour) from the eye. This type of surgery is usually done after a trabeculectomy that failed. If a person already has or is likely to form scar tissue in the eye, this type of surgery may be done at the start.
Tube-shunt surgery can be done with the person asleep (general anesthesia) or with anesthetic applied only to the eye (local anesthesia).
Most people don't have to be admitted to the hospital. But children who have the surgery may stay in the hospital overnight. And in some cases, your doctor may recommend that you stay in the hospital overnight after surgery.
You will probably see the doctor within a day after tube-shunt surgery and 2 to 5 other times during the 6 weeks after surgery, depending on your recovery.
After surgery, antibiotics may be applied to the eye. They may also be injected under the lining of the eyelid (conjunctiva) at the time of the surgery. At the end of surgery, the eyelid is usually taped shut, and a hard covering (eye shield) is placed over the eye. Corticosteroid medicines are usually applied to the eye for about 1 to 2 months after surgery to reduce inflammation in the eye.
Physical activity that might jar the eye needs to be avoided after surgery. For several weeks after surgery, you will probably need to avoid bending, lifting, and straining.
After surgery, people who have problems with constipation may need to take laxatives to avoid straining while trying to pass stools. Straining can raise the pressure inside the eye. Your doctor may suggest wearing a shield at night to avoid rubbing the eye when you sleep.
Tube-shunt surgery is most often used for people who have had previous trabeculectomy surgery that was not successful, usually due to scarring.
Tube-shunt surgery is also frequently used to treat glaucoma when a person has a:
More than half of tube-shunt surgeries are successful. This surgery has been shown to reduce intraocular pressure (IOP) and the need for further glaucoma treatment.footnote 1
Complications of tube-shunt surgery that may occur right after surgery include:
Late complications of tube-shunt surgery include:
CitationsGedde SJ, et al. (2009). Three-year follow-up of the tube versus trabeculectomy study. American Journal of Ophthalmology,148(5): 670–84.
Current as of: August 31, 2020
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Christopher J. Rudnisky MD, MPH, FRCSC - Ophthalmology
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