All you need to know about trabeculectomy surgery for glaucoma

Written by: Miss Anna Bhan
Edited by: Conor Lynch

We were fortunate enough to recently catch up with Miss Anna Bhan, a highly esteemed London-based consultant ophthalmologist, to find out what exactly trabeculectomy surgery for glaucoma entails, as well as what factors help the overall success of the operation.

What is trabeculectomy surgery for glaucoma?

It is a kind of glaucoma surgery that involves making a drainage valve in the eye tissue, to allow fluid to drain out of the eye, thereby lowering the pressure. Fluid collects under the conjunctiva, which is the thin lining over the tough outer coat of the eye (the sclera), and the drainage valve is usually sited hidden under the eye lid area. That is why it is not visible in most people.


Who is best suited for the procedure?

There is a trend towards having glaucoma surgery earlier in the course of glaucoma treatment, but usually, most people would consider it when their eye pressure is not controlled despite the use of glaucoma eye drops. Older people usually have a better healing response to the surgery and usually do well.


What is the success rate of the procedures?

My published outcomes of trabeculectomy surgery show that after two years, the majority of patients are well controlled and over 80 per cent of people will still be off all glaucoma drops. The remainder are likely to be controlled with one drop only rather than the several drops they were likely to be taking prior to surgery.


What factors help the success rate?

Currently, ophthalmologists are trying to reduce the use of preservatives in glaucoma drops as this helps reduce inflammation after surgery, which can contribute to excessive scarring. Before surgery, it is possible to switch to preservative-free medications, but it is also possible to use a short course of steroids to help dampen down inflammation.


After surgery, in the early stages, the eye is very delicate and can drain too much. This can then cause a visual problem. Hence, it is very important to rest after surgery and not to do anything too strenuous in the first few weeks.


The main drops after surgery are steroids to reduce inflammation and antibiotics to prevent infection. Regular use of the drops after surgery will help the operation succeed.


How long does it take to heal after trabeculectomy surgery?

Most people would be fully healed and would be aiming to stop all treatment after roughly three months after surgery. Some patients have steroid drop treatment for a few longer. Around that time, review is less frequent and would usually be around three months later. Most people could then go to their optician for new glasses as glasses prescription may change.


Miss Anna Bhan is a highly accomplished and revered London-based consultant ophthalmologist who specialises in conditions such as trabeculectomy surgery for glaucoma. Consult with her today by visiting her Top Doctors profile.

By Miss Anna Bhan

Miss Anna Bhan is a well-renowned consultant ophthalmologist on Harley Street in London who specialises in cataract and glaucoma surgery. Miss Bhan’s other areas of expertise include YAG laser capsulotomy, ocular hypertension, iStent and emergency eye care.

Miss Bhan graduated in medicine from the University of Manchester in 1993. She went on to specialise in ophthalmology and entered the specialist register with the Royal College of Ophthalmologists in 2005.

Her clinical background has been underpinned by glaucoma fellowships with Mr Eammon O’Neill and Professor Peter Shah in Birmingham and a neuro-ophthalmology fellowship with Mr Mike Burdon. With over 16 years of experience as a consultant, Miss Bhan has become a leading expert in her field, especially regarding glaucoma treatments and the implementation and running of virtual and minor eye conditions clinics. She also has considerable experience working with high-risk cases and comorbidities, and collaborating with community optometrists to provide shared care to patients.

Miss Bhan has been an investigator on both academic and industry-sponsored studies. She has published over 30 peer-reviewed manuscripts, a BMJ book and 26 congress posters. She has given over 15 oral presentations at both national and international congresses. She has also contributed to 14 invited talks.

In addition to her clinical work and research, Miss Bhan is a highly-esteemed voice in ophthalmological education, teaching medical students in the Royal College’s microsurgical skills course. She also regularly trains junior eye surgeons at the Central Middlesex Hospital.

Miss Bhan is one of the first glaucoma consultants to trial new simulated glaucoma surgical models and is now the Regional Simulation Lead for North West London.

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