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Trabeculectomy, also called Filtration Surgery, is a surgical procedure performed for treatment
of glaucoma. The treatment involves removing part of the trabecular meshwork and creating
a new escape route for the aqueous humor. When successful, it allows the aqueous fluid
to drain from the eye into an area underneath the conjunctiva where it is subsequently absorbed
by the body's circulatory system or filtered into tears.
In this procedure: - A conjunctival pocket is created and maybe
treated with Mitomycin or other antimetabolites for a few minutes. These drugs are used to
prevent scarring of the operation site. Scarring, if occurs, may clog the new drainage canal,
and is therefore the major reason the procedure may fail.
- A half thickness flap is then made in the sclera and is dissected all the way to the
clear cornea. - A block of scleral tissue including part
of the trabecular meshwork and Schlemm's canal is then removed to make a hole into
the anterior chamber of the eye. - As the iris may plug up this hole from the
inside, a piece of the iris maybe removed at this time. This is called iridectomy.
- The scleral flap is then sutured loosely back in place. These sutures can be released
gradually during a couple of weeks after surgery. This allows adjustment of the aqueous flow
in order to achieve target pressure and to avoid the complication of having a too low
intraocular pressure. - The conjunctiva is sewn back in place to
cover the area. After surgery, aqueous humor drains into a
filtering area called a "bleb" under the conjunctiva. Since the surgery is usually performed near
the top of the eye, the bleb can easily be concealed behind the upper eyelid.