Trabeculectomyalso known as Trab

Trabeculectomy is a common surgical option for lowering eye pressure in moderate-to-advanced glaucoma. During the procedure, the surgeon creates a tiny drainage flap under the upper eyelid so fluid can leave the eye more easily. By easing fluid build-up, the surgery helps protect the optic nerve and slow vision loss.[1][2]

Under local anesthesia, a partial-thickness scleral flap is fashioned and a tiny window is removed from the trabecular meshwork. The flap is sutured loosely so fluid can filter into a subconjunctival “bleb.” Surgeons may apply anti-scarring medicines such as mitomycin-C or 5-fluorouracil, or combine the surgery with minimally invasive stents if more pressure control is needed.[3][4]

Trabeculectomy is generally recommended for people with open-angle or angle-closure glaucoma whose eye-drops and laser treatments no longer keep pressure low enough, or for those unable to tolerate multiple medications. It is also considered first-line for some patients with very high eye pressure, extensive optic-nerve damage, or poor access to ongoing medical therapy.[5][6]

In the United States, the total charge (facility, surgeon, and anesthesia fees) typically ranges from USD $3,500 – $8,000 per eye, with out-of-pocket costs depending on insurance coverage and deductibles. Long-term studies show fewer medication costs after successful surgery, making trabeculectomy a cost-effective option for many patients compared with lifelong multi-drug regimens.[7][8]

Benefits: Can lower eye pressure by 30–50 %, reduce or eliminate drops, and is effective across nearly all glaucoma types. Limitations: Success depends on healing; scarring can close the flap. Possible complications include infection, cataract formation, transient blurred vision, or very low pressure (hypotony). Careful follow-up helps detect and treat these issues early.[9][10]

Most people return to light activities within a week but should avoid heavy lifting, bending, or eye rubbing for about a month. Post-op visits are frequent at first so the surgeon can adjust sutures or add anti-scarring injections if needed. Lifelong annual exams remain essential because glaucoma damage can still progress if pressure rises again.[11][12]

Recent trials are exploring biodegradable collagen matrices, micro-shunts, and sustained-release anti-fibrotic agents to improve long-term bleb function with fewer side-effects. Studies also show that adjustable-suture techniques and laser suture-lysis can individualize pressure targets and enhance success.[13][14]

If you think trabeculectomy might help you, keep a log of your eye-pressure readings, current medicines, and any side-effects. Bring this information to an appointment with a glaucoma specialist. You can connect with the right specialist on Kerbside for a medical education consult—no physician-patient relationship will be established.[15][16]