Trabectome eye surgery is a minimally invasive procedure for individuals managing glaucoma. It aims to improve the eye’s natural fluid drainage system to control intraocular pressure. This surgical option can help many patients potentially reduce their reliance on daily glaucoma medications or achieve better pressure control.
Understanding Glaucoma and Its Impact
Glaucoma refers to a group of eye diseases that cause damage to the optic nerve, the bundle of nerve fibers transmitting visual information from the eye to the brain. This damage frequently results from elevated intraocular pressure (IOP), the fluid pressure inside the eye. The eye constantly produces a fluid called aqueous humor, which normally drains through a mesh-like tissue known as the trabecular meshwork. When this drainage system becomes less efficient or blocked, fluid accumulates, increasing pressure on the delicate optic nerve.
Over time, sustained high intraocular pressure can lead to irreversible damage to the optic nerve fibers. This damage typically begins by affecting peripheral vision, often progressing unnoticed in its early stages, earning glaucoma the nickname “the silent thief of sight.” The most common form, primary open-angle glaucoma, accounts for approximately 90% of all cases and involves a gradual clogging of the eye’s drainage canals. Managing intraocular pressure is therefore central to preserving vision and preventing further optic nerve deterioration.
The Trabectome Procedure Explained
The Trabectome procedure is a minimally invasive glaucoma surgery (MIGS) that targets the eye’s natural drainage pathway. This outpatient procedure uses local anesthesia with intravenous sedation. A tiny incision, often around 1.7 millimeters, is made in the periphery of the cornea. Through this opening, a specialized handpiece is inserted into the anterior chamber, the front part of the eye.
The tip of the Trabectome handpiece is positioned into Schlemm’s canal, a circular channel located behind the trabecular meshwork. Using an electrosurgical pulse, the device removes a small section of the diseased or clogged trabecular meshwork tissue. This “unroofs” Schlemm’s canal, creating a direct pathway for aqueous humor to drain from the anterior chamber into the canal and subsequently into the eye’s collector channels. It also uses active irrigation and aspiration to maintain a clear view and remove tissue debris during the procedure, which takes between 5 to 15 minutes.
Recovery and Expected Outcomes
Following Trabectome surgery, patients can return home the same day. An eye patch or shield is worn overnight and at bedtime for up to a month to protect the eye. Post-operative care involves using prescribed eye drops to prevent infection and reduce inflammation. Mild discomfort, redness, and increased tearing in the operated eye are common for a few days.
Blurry vision is a temporary effect, lasting several weeks or up to two months as the eye heals. Patients are advised to avoid strenuous activities, heavy lifting, bending, and straining for about four weeks post-surgery. The primary goal is to lower intraocular pressure, with studies indicating an average reduction of approximately 30% or to a mid-teen range. Many patients also experience a reduction in their need for glaucoma eye drops.
Considering Trabectome: Candidacy and Potential Risks
Trabectome surgery is for patients with open-angle glaucomas, including primary open-angle glaucoma and certain secondary forms. It is considered when eye drops or laser treatments have not adequately controlled intraocular pressure. The procedure can be performed alone or combined with cataract surgery. Patients with conditions like neovascular glaucoma, chronic angle-closure glaucoma, or active inflammation are not considered suitable candidates.
While Trabectome is safer compared to more invasive glaucoma surgeries, risks exist. Temporary complications can include blood in the eye (hyphema) or a transient increase in eye pressure immediately after surgery. Though rare, more serious complications like infection (endophthalmitis) or choroidal detachment can occur. Scarring at the surgical site, which might necessitate further intervention, is possible. A thorough discussion with an ophthalmologist can help determine if this procedure aligns with an individual’s eye health needs.