Trabeculectomy: Before Your Surgery

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What is a trabeculectomy?

Eyeball and optic nerve

Trabeculectomy (say "truh-BEK-you-LEK-tuh-mee") is surgery to treat glaucoma. Glaucoma is an eye disease. It occurs when the nerve that connects the eye to the brain gets damaged. This damage is often caused by extra pressure in the eye. Over time, this pressure can lead to vision problems.

This type of surgery is one way to lower the pressure in the eye. It is sometimes called glaucoma filtration procedure.

First, the doctor puts numbing medicine in your eye. Then the doctor uses special tools and a microscope to make a cut in the white part of your eye. This cut is called an incision. Next, the doctor removes a tiny piece of your eye and makes an opening for fluid to drain out of your eye. Then he or she closes the incision with stitches.

After surgery, tissue rises over the new opening to make a little blister or bubble on the surface of your eye. This is called a bleb. Extra fluid from your eye will go from the opening into the bleb. Then it gets absorbed by the thin cover on the outside of your eye. You will not feel the fluid. And in most cases, the upper eyelid covers the bleb and it can't be seen.

You may get medicine to make you sleep during the surgery. Or you may be awake, but you will get medicine for pain. The surgery will take about 30 to 90 minutes. You can expect your eye to feel better each day. But it may take 6 to 8 weeks to fully heal.

This surgery may prevent your vision from getting worse. You may also be able to take less glaucoma medicine than before. To make sure that the bleb works well, you may need to see your doctor many times after surgery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines, including natural health products, such as vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take 30 to 90 minutes.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.
  • You may have a patch or shield over your eye. Your eye may be taped shut.
  • You will get drops or antibiotics in your eye or under your eyelid.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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