Glaucoma is commonly associated with a build up of fluid pressure inside the eye. Eye pressure increases because the eye’s fluid drainage channels become blocked.
The tip of Trabectome uses an electrical pulse to precisely remove a strip of the blocked drainage channel, helping to re-establish the eye’s own natural drainage pathway and lower eye pressure.
The Trabectome is suitable for patients with mild to moderate open angle glaucoma who are going to have cataract surgery and wish to reduce their need for glaucoma medications.
The Trabectome is not suitable for advanced glaucoma or where the natural drainage system of the eye is severely damaged.
The Trabectome is used to lower eye pressure and reduce the need for daily glaucoma eye drops.
Clinical studies show an average reduction in eye pressure of 25% following treatment with the Trabectome.¹ Many patients are also able to reduce the number of medications they need to take. However, most patients require at least one medication to control eye pressure.
The Trabectome will not cure your glaucoma, reverse any damage already caused by glaucoma, or bring back any lost vision.
The Trabectome procedure is typically performed at the end of cataract surgery and takes approximately 10 minutes. The Trabectome is inserted through the same small incision used in cataract surgery, therefore no additional incisions are required. The tip of the probe is used to precisely remove a small segment of the blocked drainage channel, helping to re-establish the natural drainage of the eye and lower eye pressure. During the procedure a continual wash removes tissue debris and controls the temperature.
The operation is usually performed under a local anaesthetic, meaning that you are awake but your eye is numb so you will not feel anything.
The Trabectome procedure will begin to work straight away to lower your eye pressure and you can usually stop taking your glaucoma drops in the operated eye. Any drops you use in your other eye must be continued as normal.
Following cataract surgery, you will be given new anti-inflammatory and antibiotic eye drops to use for 4 weeks to prevent inflammation and infection.
It is normal for your vision to be blurry following the surgery and this may take several days to improve.
As with all eye surgery, you should avoid heavy lifting or straining for at least a week. Most people take 1 – 2 weeks off work after surgery, however the length of time will depend on the nature of your work.
In some cases the Trabectome may not lower eye pressure or its effect may wear off with time. If this is the case, you may need to restart your glaucoma medications or have further procedures to control your eye pressure. The Trabectome does not reduce the chance of subsequent surgery from working.
The iStent, Hydrus, and CyPass are alternative minimally invasive procedures that can be performed at the time of cataract surgery to lower eye pressure in patients with open angle glaucoma.
Non-surgical alternatives include continuing to use eye drops to lower eye pressure or a laser procedure called selective laser trabeculoplasty.
1. Jordan, J. F., Wecker, T., van Oterendorp, C., Anton, A., Reinhard, T., Boehringer, D., & Neuburger, M. (2013). Trabectome surgery for primary and secondary open angle glaucomas. Graefe’s Archive for Clinical and Experimental Ophthalmology, 251(12), 2753-2760.
Mr Keith Barton is a glaucoma specialist whose research interests include the surgical management of glaucoma, specifically secondary glaucomas and the use of aqueous shunt devices and minimally invasive glaucoma devices.
Dr Nathan Kerr is a glaucoma specialist at the Royal Victorian Eye & Ear Hospital and Eye Surgery Associates in Melbourne, Australia. He completed his fellowship at Moorfields Eye Hospital in London and specialises in minimally invasive glaucoma surgery.