What is included in the surgical planning prior to performing trabeculectomy?

Updated: May 18, 2020
  • Author: Maria Hannah Pia Uyloan de Guzman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Answer

Surgical planning

  • Determine target IOP. Lower IOP needs more intensive anti-inflammatory therapy and looser flap sutures.

  • Consider type of glaucoma. This influences the target IOP and the risk of aqueous misdirection.

  • Review risk factors for failure. More risk factors needs more anti-inflammatory/antifibrotic therapy.

  • Consider using antifibrotic agents (for lower target IOPs and higher risk of failure).

  • Determine route, dose, and duration of corticosteroid treatment.

  • Consider need for postoperative cycloplegia (especially for shallow anterior chambers such as in angle-closure glaucoma).

  • Plan tightness of scleral flap sutures (target IOP, risk of hypotony).

  • Discontinue anticoagulant medications, if possible.


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