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What is Trabeculoplasty?

By D. Jeffress
Updated May 17, 2024
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Trabeculoplasty is a painless, noninvasive surgical procedure to treat the eye disorder glaucoma. A high-intensity light beam is used to stimulate drainage channels in the eye, which helps to relieve pressure and stop fluid accumulation. Doctors generally recommend the surgery after medications have proven ineffective at treating a patient's symptoms. In most cases, an ophthalmologist can perform trabeculoplasty in a matter of minutes in his or her own office. There are very few risks of complications, and the majority of patients experience near full relief from glaucoma for several years following surgery.

There are a few different types of glaucoma, and trabeculoplasty is not appropriate for all conditions. A common variety called open-angle glaucoma is a chronic, progressive disorder in which the channels that drain fluid stop functioning. A clear fluid called aqueous humor builds up in the eye, which puts pressure on the optic nerve and other important structures. Trabeculoplasty can be considered for open-angle glaucoma if eye drops and oral drugs do not improve drainage.

Trabeculoplasty is typically performed on an outpatient basis at a surgical center or ophthalmologist's office. Before surgery, medicated eye drops are administered to reduce moisture and temporarily lower pressure around the optic nerve. The doctor then uses a specialized microscope called a slit lamp to inspect the drainage channels in the corner of the eye. With the aid of the slit lamp, a hand-held laser device is used to burn several tiny marks in channel tissue. The procedure re-stimulates channels and improves their functioning.

Most trabeculoplasty surgeries can be completed in less than ten minutes. Following surgery, a patient is usually asked to stay in the office for one to two hours so the doctor can monitor recovery. Temporary effects may include cloudiness in the eye, fuzzy vision, and mild soreness that usually go away in less than four hours. It is possible, though unlikely, for pressure to dramatically increase shortly after surgery. If pressure spikes occur, emergency surgery may be needed to prevent sudden blindness.

The success rate is very high for trabeculoplasty. Many people are completely cured, but about 25 percent of patients experience recurring glaucoma after about five years. As long as scar tissue does not develop in the channels, additional rounds of laser surgery can usually be performed. Invasive surgery to remove or permanently open a channel is an option if trabeculoplasty does not work or if problems keep coming back.

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