Trabeculotomy for Childhood Glaucoma

Surgery Overview

Trabeculotomy is a surgical procedure that lowers the pressure in the eye. The surgeon will locate the drainage angle of the eye and insert a tool to make the opening bigger. This wider opening allows fluid (aqueous humor) to drain out of the eye. Trabeculotomy is a surgery for children only.

What To Expect

If the doctor prescribed eyedrops, use the drops exactly as directed. Your child will probably need to wear an eye patch following surgery. Your child will also need to avoid strenuous activities for as long as the doctor recommends.

Why It Is Done

Trabeculotomy is a good choice for children who have 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. They also do a better job of lowering eye pressure in children who have glaucoma.

How Well It Works

One year after surgery, trabeculotomy was successful for more than 80 out of 100 children who didn't have glaucoma at birth.^{footnote 1}

Risks

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.