Trabeculoplasty

In a normal healthy eye, aqueous humour, a clear liquid produced by the eye, travels around the lens and drains out through the trabecular meshwork. However, sometimes, there is a blockage in the flow of aqueous humour, resulting in increased intraocular pressure (IOP) within the eye. This condition is known as glaucoma. Trabeculoplasty is a laser surgery to treat open-angle glaucoma by lowering the intraocular pressure within the eye and correcting the drainage angle. 

Your doctor may recommend trabeculoplasty surgery if you have glaucoma that does not get better with other treatment options. It can be used to treat primary, secondary, open-angle or ocular hypertension glaucoma. 

1. Primary glaucoma: When there is no underlying health condition for the occurrence of glaucoma, the condition is known as primary glaucoma. Most cases of primary glaucoma are open-angle glaucoma. 
2. Secondary glaucoma: Existing eye conditions such as injuries, inflammations, or cataracts elevate the eye pressure, leading to secondary glaucoma. 
3. Open-angle glaucoma: A condition in which trabecular meshwork is open but does not allow the aqueous humour to drain adequately. 
4. Ocular hypertension: There is an above-average pressure in the eye with no detectable changes in vision or damage to the optic nerve. 

People with the following symptoms of glaucoma may need trabeculoplasty:-

1. Nausea
2. Vomiting
3. Severe headache
4. Red eyes
5. Severe eye pain
6. Blurred or low vision
7. Seeing halos around light
8. Patchy blind spots
9. Tenderness around the eyes

1. Before the procedure, you will be advised for a pre-anaesthetic checkup. 
2. The doctor will ask you about the history of your eye problems and perform diagnostic tests like gonioscopy (examines the drainage angle), pachymetry (measures corneal thickness), and tonometry (measures intraocular pressure). 
3. He/she may also examine your optic nerve and visual field. 
4. Because trabeculoplasty treatment does not involve making any incisions, you can eat and drink as you like before the procedure. 
5. You can also continue to take all your glaucoma and other medications as usual. 
6. Your doctor will then explain the procedure, estimated cost, and insurance formalities. 
7. He/she will also advise you to ask a friend or family member to drive you home after the procedure.

1. You will be asked to sign a consent form on the day of the procedure. 
2. The doctor will examine your vision and IOP two hours before the procedure. 
3. He/she will also administer eye drops to lower the pressure in your eyes.

1. The surgeon will ask you to sit in front of a laser instrument with your chin placed on a chin rest and forehead relaxed against a headpiece.
2. He/she will administer anaesthetic eye drops to numb the eye. 
3. Then the surgeon will place a special lens on your eye to restrict eye movement and perform the procedure. 
4. Once the surgery is completed, he/she will remove the special lens, rinse your eyes, and administer additional eye drops to keep the eye pressure down and avoid the risk of infection. 
5. Usually, the procedure is completed within 10-15 minutes. 

At the doctor’s office:-

1. The surgeon will ask you to sit in the waiting room for 30 minutes to an hour. 
2. Your surgeon will check the intraocular pressure in your eye an hour after the procedure. 
3. If your eye pressure is normal, you can go home immediately. 
4. If the eye pressure has increased, you may need to stay in the office for additional treatments until the pressure comes down.
5. You will get a discharge on the same day of the procedure. 

At home:-

1. It is normal to experience blurry vision a few hours after the procedure.
2. Avoid driving on the day of the surgery.
3. You will not be required to wear an eye patch after the procedure. 
4. Continue your eye drops and medications after surgery to keep the eye pressure under control. 
5. Your doctor may prescribe anti-inflammatory drops. 
6. You can resume your normal activities on the same day as the procedure. 

The appointments for your follow-up visits depend on your surgeon and the type of glaucoma you have. Your doctor will typically schedule your first follow-up appointment one to two weeks after the surgery. He/she will check your eye pressure during the visit and provide instructions for further follow-up appointments.

Although complications associated with a trabeculoplasty procedure are rare, some of the possible risks include:-

1. A rise in eye pressure
2. Vision loss
3. Blurry vision
4. Pain or redness
5. Inflammation of the iris
6. Irritation on the eye’s surface
7. Temporary clouding of the cornea
8. Eye infection
9. Fluid leakage from the surgery site
10. Bleeding inside the eye
11. Cataract

Call your healthcare professional if you experience the following symptoms:-

1. Severe pain
2. Decreased vision
3. Abnormal discharge from the eye