Trabeculotomy for Glaucoma
Trabeculotomy is a surgical procedure much
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
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
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
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
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
- 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).
permanent loss of central vision.
- Infection in the
- 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
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
Surgery is more difficult
and less likely to be successful for children who have severe congenital
Medicines 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.
Kipp MA (2003). Childhood glaucoma. Pediatric Clinics of North America, 50(1): 89-104.
Primary Medical Reviewer
||Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer
||Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
||May 5, 2010