Trabeculectomy is a surgical treatment or operation that treats glaucoma.

A painless outpatient laser treatment for glaucoma is the YAG laser iridotomy.

Glaucoma is the second leading cause of blindness in the world. Studies to date show that approximately 2-3% of the population over the age of 40 suffer from some form of glaucoma, and it is estimated that in as many as 50% of cases it is unrecognizable.

Elevated intraocular pressure is considered a major risk factor for developing glaucoma. Some values may indicate symptoms of intraocular pressure.

Normal intraocular pressure ranges from 8 to 21 mmHg. According to some statistics, the upper normal value is 22 mmHg or even 24 mmHg. It is important to note that any increase in intraocular pressure does not mean that a person has glaucoma.

Glaucoma is defined as damage to the optic nerve as a result of elevated intraocular pressure. For its diagnosis, we must have some changes in the optic nerve. If we only have high eye pressure, it is called ocular hypertension. If we have damage to the optic nerve, which is characteristic of the appearance of glaucoma, and at the same time normal intraocular pressure, it is called normotensive glaucoma.

The mechanism of glaucoma is different, therefore, based on that there are different divisions of glaucoma, and from there different types of treatment. Common to all is the excessive amount of aqueous humor that is retained in the eye, or its disturbed flow leading to accumulation and high pressure on the structures in the eye.

Sometimes the stagnation is due to the anatomical structure of the eye, other times as a result of the deposition of various substances in the drainage system of the eye.

Untreated glaucoma can lead to complete damage to the optic nerve resulting in blindness.

The symptoms of glaucoma depend on the stage and type of disease and can be unrecognizable for a long time. In the early stages it is usually asymptomatic and is therefore often referred to as the “silent thief” of vision.

Open-angle glaucoma usually has no symptoms. Very often patients present after ocular nerve damage and changes in the visual field.

On the other hand, the symptoms of closed-angle glaucoma can be very distressing and are manifested with:

• Extremely high intraocular pressure;
• Significant decrease in visual acuity;
• Tunnel vision;
• Pain in the eye area;
• Headache;
• Nausea and vomiting.

It is often inherited, but not always. With age, the risk of glaucoma is higher, and it can occur in children. Children with glaucoma usually have big eyes (doll eyes), because the eye is more stretched in conditions of high intraocular pressure.

Causes of glaucoma

Causes that can affect the occurrence of glaucoma are:

• Living age over 45 years;
• Presence of glaucoma in the family;
• In patients with high blood pressure, hypothyroidism, diabetes;
• Due to frequent and long-term corticosteroid therapy;
• Eye injuries;
• Eye infection;
• Blocked blood vessels inside the eye;
• Increased prevalence in people with dark skin due to the anatomical features of the eyes;
• Very rarely, a specific intervention that is used to treat another eye problem can cause glaucoma.

Prevention of glaucoma is not possible, but early detection of the disease and its significant delay is possible:

• If there is glaucoma in the family, a complete examination should be done occasionally;
• For people over 65, it would be good to have their eye pressure checked every two years, regardless of whether there are any symptoms;
• If the disease has already been diagnosed, the prescribed therapy should be used regularly and monitored regularly.

In our clinic there is an opportunity to perform a complete diagnosis of glaucoma in one day. The review consists of:

• Measurement of intraocular pressure;
• Measurement of the thickness of the cornea – in order to specify the height of the intraocular pressure;
• Measuring the daily curve at different times of the day;
• Field of view analysis;
• Ocular nerve analysis with OCT (Optical Coherence Tomography).

OCT (Optical Coherence Tomography) – is a standard tool for diagnosing and monitoring glaucoma. It is used to analyze the optic nerve, whether damage has occurred and its progression.

Visual field – this examination checks the central and lateral vision (peripheral vision). The perimeter serves to detect changes in vision, i.e. its weakening that may be caused by glaucoma.

All diagnostic tests are painless and are performed in collaboration with the patient.

YAG laser iridotomy is a procedure used in patients with closed-angle glaucoma. During this photo disruption treatment, small microscopic openings are made, creating communication between the posterior and anterior ocular chambers. This allows uninterrupted flow of aqueous humor and prevents an increase in intraocular pressure.

The preparation is initiated by the nurse, during which the vision, tonus and refractive measurements are taken again.

The patient is then transferred to the preoperative block and a history is taken. Blood pressure and blood sugar are checked. Then, in consultation with the ophthalmic surgeon, if necessary, additional diagnostic tests are performed.

Patients with chronic systemic diseases, depending on the therapy they receive, have special preparations for which they are informed on the day of the operation.

Once the patient is fully prepared, they are admitted to the operating room.

The patient is placed on the operating chair where anesthetic drops are instilled. The operation can take about an hour.

The anesthesiologist is responsible for monitoring vital functions, ECG, blood pressure, respiration and oxygenation as well as controlling anesthesia.

Trabeculectomy is a standard operation for glaucoma that reduces the pressure in the eye. During this operation, a small hole is made in the wall of the eye to allow the accumulated fluid to come out of the eye in a controlled manner.

During the operation, the patient is awake, communicative and feels no pain.

After the operation, the patient is taken to an apartment. About half an hour after the operation the patient is checked out of the hospital (one-day surgery) without bandages, except at the request of the patient.

The patient also receives written guidance on limitations and postoperative care.

The following day is scheduled for a regular follow-ups. This precedes a follow-up after one week, then two weeks based on the assessment of the ophthalmic surgeon.

Appropriate antibiotic and corticosteroid therapy in the form of drops is prescribed which the patient should use according to the instructions of the ophthalmic surgeon. The patient is also educated about filtration bubble massage.

Normal symptoms after surgery are redness and a tingling sensation. If the patient experiences symptoms such as severe pain in the eye area or changes in vision, it is advisable to contact the ophthalmologist immediately.

Restrictions after the intervention are temporary and do not last long and are always in accordance with the surgeon’s recommendation.

The patient should avoid rubbing the eye, strenuous exertion as well as lifting heavy objects. Physical activity is not recommended until the ophthalmic surgeon decides otherwise.

After the operation, the patient can wash his face and take a bath normally, without restrictions.

Medical staff are available 24/7 for any consultation required after the intervention.

The surgical treatment package includes: intervention with general anesthesia, preoperative preparation; three follow-ups.

There is an opportunity to pay in installments without interest and additional costs.

You can check more about the payment method on the current price list of Sistina Ophthalmology.