Trabeculectomy in pregnancy: Case studies and literature review

Glaucoma management during pregnancy is a challenge for the patient and doctor. During pregnancy, the intraocular pressure (IOP) decreases. However, some women with preexisting glaucoma have elevated IOP requiring enhanced medical treatment. Glaucoma refractory to medical treatment combined with disease progression may necessitate laser trabeculoplasty or surgical intervention. Surgery during pregnancy has potential risks for both the mother and fetus. The challenges include problems with anesthesia, positioning for surgery, difficulties in the surgical procedure, potential risk with antimetabolites, and concerns with the management of postoperative complications. We report two case scenarios that highlight the challenges associated with trabeculectomy in pregnant women and the modifications that can be adopted to improve safety and the efficacy of glaucoma filtering surgery during pregnancy.