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Trabeculectomy: Does It Have a Future?

Aparna Rao1, Rakhi D Cruz1

  • 1Glaucoma, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, IND.

Cureus
|September 16, 2022
PubMed
Summary
This summary is machine-generated.

Trabeculectomy (TRAB) remains a vital glaucoma surgery, especially for advanced cases. This review compares TRAB to newer procedures, assessing its future role and providing a decision-making algorithm for surgeons.

Keywords:
glaucoma surgeryminimally invasive glaucoma surgeriesnon-penetrating glaucoma surgeryphacotrabeculectomytrabeculectomy

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Management

Background:

  • Trabeculectomy (TRAB) is a cornerstone glaucoma surgery with ongoing modifications.
  • Complications, particularly with anti-fibrotic agents, remain a concern.
  • Newer non-penetrating glaucoma surgeries challenge TRAB's dominance.

Purpose of the Study:

  • To review the evolution and efficacy of trabeculectomy.
  • To compare trabeculectomy outcomes with newer glaucoma shunt procedures.
  • To predict the future role of trabeculectomy in modern glaucoma surgery.

Main Methods:

  • Comprehensive literature review comparing trabeculectomy outcomes and complications.
  • Analysis of efficacy against neoteric glaucoma shunt procedures.
  • Development of a surgical decision-making algorithm.

Main Results:

  • Trabeculectomy remains the gold standard for specific patient groups requiring very low intraocular pressures.
  • Comparison highlights varying success rates and complication profiles between TRAB and shunt procedures.
  • The review provides a framework for selecting the optimal surgical technique.

Conclusions:

  • Trabeculectomy continues to be a critical procedure for advanced glaucoma.
  • Understanding its evolution and comparative efficacy is essential for surgical planning.
  • The proposed algorithm aids surgeons in choosing the most appropriate glaucoma surgical intervention.