Trabeculectomy in Ahmedabad — Glaucoma Filtration Surgery at Puja Eye Hospital

Trabeculectomy is the most established and widely performed surgical procedure for glaucoma worldwide. It creates a new drainage pathway for fluid to leave the eye, significantly lowering intraocular pressure and protecting the optic nerve from further damage.

At Puja Eye Hospital, trabeculectomy is performed by Dr. Puja Sheth in a fully equipped modular ophthalmic operation theatre using a Zeiss surgical microscope — the gold standard for precision eye surgery globally.

What Is Trabeculectomy?

Trabeculectomy is a filtration surgery — it creates a controlled, surgically made opening in the wall of the eye through which the aqueous fluid can drain out of the eye and be absorbed by the surrounding tissues. This new drainage route bypasses the eye’s blocked or dysfunctional natural drainage system, effectively lowering the eye pressure to a safer level.

The surgery creates a small blister-like reservoir under the conjunctiva (the transparent membrane covering the white of the eye) called a bleb. The bleb is the visible evidence that fluid is draining successfully through the new pathway.

When Is Trabeculectomy Recommended?

Trabeculectomy is typically recommended when:

Eye pressure remains uncontrolled despite maximum tolerated medical therapy (eye drops and tablets)
Glaucoma is progressing — the optic nerve or visual field is continuing to deteriorate despite treatment
The patient is unable to tolerate or consistently use the required number of eye drops
The target eye pressure required to protect the optic nerve is very low — lower than can be achieved with drops alone
Advanced glaucoma is present, where a significant and sustained reduction in eye pressure is essential
The patient requires a surgical option that can provide long-term pressure control without daily drops

What to Expect — Before, During, and After Surgery

Before Surgery

A pre-operative assessment is conducted to evaluate the health of the eye and to plan the surgical approach. Certain eye drops may need to be adjusted before surgery. You will receive detailed instructions on fasting, medications to pause, and what to expect on the day.

During Surgery

Trabeculectomy is performed under local anaesthesia with sedation. You will be comfortable and relaxed throughout. The surgery takes approximately 45 to 60 minutes. The operating surgeon works under the Zeiss surgical microscope, which provides outstanding illumination and magnification for precise tissue work.

An antifibrotic agent (Mitomycin C or 5-Fluorouracil) may be applied during the surgery to reduce scarring around the bleb and improve the long-term success rate of the procedure.

After Surgery

You will be monitored for a few hours after surgery before discharge. A protective eye shield is worn overnight. Anti-inflammatory and antibiotic eye drops are prescribed and must be used diligently in the post-operative period.

Follow-up visits in the weeks after surgery are important, as the eye pressure and bleb function need to be carefully monitored and adjusted. Certain procedures — such as suture adjustment or bleb massage — may be performed in the clinic to optimise the drainage. Most patients notice a significant reduction in eye pressure within the first few weeks after surgery.

How Effective Is Trabeculectomy?

Trabeculectomy is highly effective at lowering intraocular pressure. The majority of patients achieve a significant and sustained reduction in eye pressure after the procedure, and many are able to reduce or eliminate their dependence on pressure-lowering eye drops.

Long-term success depends on bleb function. In some patients, the bleb may scar over time, reducing its effectiveness. Antifibrotic agents used during surgery improve long-term outcomes. If the bleb fails, further surgical intervention may be required.

Puja Eye Hospital- Glaucoma Eye Hospital

Protect Your Vision — Book a Glaucoma Evaluation Today

Call or WhatsApp Dr. Puja Sheth: +91 8780012121 Puja Eye Hospital, Naranpura, Ahmedabad | Mon–Sat: 9:30 AM – 4:30 PM

FAQs

Is trabeculectomy a major surgery?

Trabeculectomy is a microsurgical procedure performed under local anaesthesia. While it is more involved than a laser procedure, it does not require general anaesthesia in most cases, and most patients go home the same day or the day after surgery. It is not open surgery in the conventional sense.

Will I still need eye drops after trabeculectomy?

Many patients are able to reduce or stop their eye drops after a successful trabeculectomy. However, some patients still require one or more drops to achieve their target pressure, particularly those with advanced glaucoma. Dr. Sheth will review your medication requirements at each follow-up visit.

What are the risks of trabeculectomy?

Like all surgical procedures, trabeculectomy carries risks. These include infection, bleeding, excessive scarring of the bleb leading to failure, very low eye pressure (hypotony) in the early post-operative period, and a small risk of cataract development or acceleration. Serious vision-threatening complications are uncommon in experienced hands. Dr. Sheth will discuss the specific risks applicable to your case before the procedure.

Can trabeculectomy be performed if I already have a cataract?

Yes. In some cases, combined surgery — trabeculectomy and cataract removal (phacoemulsification) in the same operation — may be recommended. This avoids two separate procedures and can be advantageous in selected patients. Dr. Sheth will advise whether combined surgery is appropriate in your case.

How long is the recovery period?

The initial recovery period — involving restricted activity, eye drop use, and frequent follow-up visits — lasts approximately 4 to 6 weeks. Vision may be temporarily blurred or variable during this time as the eye settles. Full stabilisation of the eye pressure and visual outcome may take 3 to 6 months.