Trabeculotomy for glaucoma

Surgery Overview

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Trabeculotomy is a surgical procedure much like trabeculectomy. A piece of tissue in the eye's drainage angle is removed to create an opening. This new opening allows fluid (aqueous humor) to drain out of the eye. Trabeculotomy is a surgery for children only.

What To Expect After Surgery

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After surgery, drops that tighten (constrict) the pupil are used to keep the iris, the colored part of the eye, from blocking the new opening.

Why It Is Done

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Trabeculotomy is a good choice for children who have congenital glaucoma when the clear covering (cornea) over the iris is cloudy.

For children, trabeculotomy or goniotomy are preferred over trabeculectomy because they are less invasive and less likely to cause cataracts.

How Well It Works

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Trabeculotomy can successfully treat congenital glaucoma 80% to 90% of the time when symptoms start when the child is 1 month to 2 years old. Trabeculotomy is not as successful in children whose glaucoma was present at birth or began late in childhood.¹

Risks

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The most common problem after trabeculotomy is scarring of the new opening in the eye. Scarring prevents fluid from draining out of the eye. Other complications of surgery may include:

• Severe blurring of vision for several weeks (common).
• Bleeding in the eye.
• Extremely low pressure in the eye, which may result in blurred vision from clouding of the lens (cataract) or fluid buildup under the nerve layer (retina).
• Sudden, permanent loss of central vision.
• Infection in the eye.
• High pressure in the eye, causing the space in the front part of the eye (anterior chamber) to collapse. This condition is called malignant glaucoma and is rare.
• Continued changes in the optic nerve at the back of the eye caused by glaucoma.

What To Think About

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Some children with congenital glaucoma need more than one surgery to control the high pressure in their eyes. Trabeculotomy has to be repeated in about 50% of the eyes of children who have the surgery.¹

Surgery is more difficult and less likely to be successful for children who have severe congenital glaucoma.

Medications may still be needed after surgery to control pressure in the eyes.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. Kipp MA (2003). Childhood glaucoma. Pediatric Clinics of North America, 50(1): 89–104.

Credits

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Author	Robin Parks, MS
Editor	Kathe Gallagher, MSW
Associate Editor	Michele Cronen
Associate Editor	Pat Truman
Primary Medical Reviewer	Adam Husney, MD - Family Medicine
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Carol L. Karp, MD - Ophthalmology
Last Updated	July 7, 2006