Trabeculectomy advice please: Hi, I am a newbie... - Glaucoma UK

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Trabeculectomy advice please

Glyndebourne profile image
35 Replies

Hi, I am a newbie to this forum. I am nearly 62, and female. I was diagnosed with advanced glaucoma in June 2024 and told I need to have a trabeculectomy in both eyes. I was completely devastated, especially as 6 months ago I had open heart surgery to have an aortic valve replacement. My consultant said that if I didn't have my left eye done soon, I could lose my sight within a year; he also said I only have about 3 years of vision with my right eye. He hopes to operate within 3 months (to operate on the left eye first, and hopefully on the right eye after 4 weeks). I would prefer to have the operation done under a general anaesthetic, but I have been advised that it will be a lot quicker if I go for a local. I am absolutely terrified, especially as I was told that it wouldn't be possible to be sedated, because that would require an anaesthetist. It was suggested I contact my GP to ask for a one off prescription for Diazepam, but this was refused as apparently the NHS stopped this last year. I would be really grateful to hear people's experiences of having a local anaesthetic, how long the surgery took, and how long it took to recover. I am really struggling to come to terms with this diagnosis; I am a musician, and the thought of losing my sight terrifies me. Many thanks.

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35 Replies
SIMONE75 profile image
SIMONE75

I’ve had a Trabulectomy and several other surgeries with local and honestly it’s less bad than going to the dentist for a clean. I would say I get nervous so I have a very low dose diazepam from my GP who just gave me six pills. If you can’t get them from your GP ask the hospital to prescribe them and if they won’t then all you can do is go for a herbal like kalms but try them out first to make sure you are ok with them. You can buy these anywhere. The best of luck.

Glyndebourne profile image
Glyndebourne in reply to SIMONE75

Thank you so much 🙂

Hypnotoad_68 profile image
Hypnotoad_68

Hi Glyndebourne.

I have had Trab surgery in both eyes with local rather than general. Surgery lasted about 30/ 40 mins in total with minimal discomfort. Aftercare was easy with drops and general day to day eye cleanliness. Understand your apprehension, but it really is a straightforward procedure. Best wishes and good luck👍

Glyndebourne profile image
Glyndebourne in reply to Hypnotoad_68

Thank you so much 😊 That is reassuring!

Dance007 profile image
Dance007

I agree with the other respondent, it was much more comfortable than going to the dentist (even for a checkup). I was anxious before the surgery, but I needn't have been if I'd realised how comfortable it would be. I think the surgery took about 15 minutes. I felt completely fine afterwards, and if it weren't for the fact I was told to take it easy for a few days, I would have happily carried on as normal.

I can't remember any pain afterwards, maybe a bit of an ache the first evening, but I can't remember needing paracetamol.

My surgeon gave me a leaflet explaining what to expect and info about aftercare and recovery. If you've not been given a leaflet the Glaucoma organisation may have some. There was a list of things to avoid, like bending and lifting. I wore wraparound sunglasses when outside for the first few days . It avoided glare and gave me confidence that I wouldn't get dust in my eye.

Although my vision was blurry for a few days it didn't take long to become clear. I can't remember how long it was before I could drive again, maybe a week. As I work at a desk I didn't need to take long off work - again, maybe a week.

If you can't get a prescription for a sedative from your GP or the hospital, a private GP might be an option, but there would be a cost to that of course. Maybe the Glaucoma organisation can advise.

I hope you get a solution soon!

Glyndebourne profile image
Glyndebourne in reply to Dance007

Thank you so much! 🙂

Sorshup profile image
Sorshup

A very sobering tale, insofar that what appears to have been your first discovery of the condition at an already advanced stage, and with very worrying prognosis by theconsultant. Having had two trabs and a trab revision, and due a second revision within a few weeks time, I can add to the reassurance you have already received regarding the op and post op.

What concerns me is the delay before surgery unless you are on drops that are successfully reducing the IOP; current standard target for late stagers like us is below 12 (there will be variation in opinion between consultants of course). eep prodding the hospital if you need to, consider going private if it makes any difference. One further point for anyone is that your IOPs should be checked the day following surgery, there can be a spike or indeed they could be too low. Thinking of you !

Glyndebourne profile image
Glyndebourne in reply to Sorshup

Thank you so much. Yes I am taking eye drops: Brinzolomide twice a day, Tiopex once a day and Latanaprost at night. After some perseverance with my consultants secretary, I have been given a provisional date of 16th September 🤞 Unfortunately I can’t afford to go privately ☹️ Thank you again for your advice 🙏

Dennis03 profile image
Dennis03

Hi!

I had a trab 4 years ago under local anaesthetic and everything went fine. The local anaesthetic is a series of eye drops at intervals and a final injection into the eye which isn't as gruesome as it sounds. The operation took about 40 minutes and I was able to leave about an hour after that. Eye drops for a couple of weeks and stitches came out after that. I did need the "needling" operation after that as the bleb wasn't quite big enough but that was a much easier and quicker procedure. Hope this helps and goes luck!

Glyndebourne profile image
Glyndebourne in reply to Dennis03

Thank you so much! 🙂

AlfredV profile image
AlfredV

Sorry to hear of your troubles. Both of my trabs were done under a general anaesthetic because they were anticipated to be complicated. My understanding is that you can request that you have them done under general anaesthetic, but it might mean having a longer wait.

I've undergone revision surgery under local anaesthetic and while I wouldn't describe it as a pleasant experience it was tolerable.

Glyndebourne profile image
Glyndebourne in reply to AlfredV

Thank you so much 🙏

Eahldt profile image
Eahldt

I would endorse what others have said about trabeculectomies under local anaesthetic. I’ve had two. It’s nothing like as bad as you imagine it will be. I had a nurse holding my hand the whole time in case I wanted to communicate. Recovery is much quicker than from a general anaesthetic.

Glyndebourne profile image
Glyndebourne in reply to Eahldt

Thank you so much 🙏

S_Miles profile image
S_Miles

I have had both eyes done and cataracts. One consultant told me younger patients get more anxious than oldies. A lot of people talk about deep breathing to stay calm but when lying down I find concentrating on regular shallow breathing is calming. Perhaps you could have some music playing in the background or on headphones. Best wishes.

Glyndebourne profile image
Glyndebourne in reply to S_Miles

Thank you so much. Good idea re music! 🙂

Popsicle57 profile image
Popsicle57

hi

I have no experience of trabeculectomy, but I hope you have gained reassurance from the excellent replies you’ve received so far.

sending my best wishes and a hug .

Glyndebourne profile image
Glyndebourne in reply to Popsicle57

Thank you so much. Yes, I have found the comments very reassuring! 🙂

PeterRabbit62 profile image
PeterRabbit62

I have Prime open angle Gluacoma and I am 63 and I have recently have a Canaloplasty and trabeculotomy along with cataract surgery in my left eye in June and I am also have other health and take lots of painkillers, I have mine done with local anaesthetic and they give me a low dose of diazepam as well, I was told I slept through it so I suppose because it's was an early morning surgery and I live 40 miles from the hospital where I was going, my surgery was 8:00 so I have to get up very early, so the strong painkillers I take at night Amitriptyline and Co-codamol and Gabapentin and the low dose of diazepam probably made me sleepy so that why I slept through. I am still in recovery and using drops that were prescription by the consultant, the recovery is going well and my sight is improving all the time I have my surgery on the 24 June and have been back to see consultant a few times and I go back in August again so the recovery is about 8 weeks and the prescription drops which are lower throughout than, yours maybe different to mine. I reckon the surgery took about 15 minutes. I have a local for my other cataract and was very nervous with that, it was painless though. Both surgeries have lower my pressures. Best wishes, good luck.

Glyndebourne profile image
Glyndebourne in reply to PeterRabbit62

Thank you so much. Good luck with your recovery 🙂

Moultrey profile image
Moultrey

Glyndebourne,

Pls don’t vex over it…you’ve had heart surgery and to me that’s more scary than this.

I had my trab done 5 months ago and experienced nothing out of the ordinary, post surgery a little watery eye but careful to heed the instructions they give you.

I was awake but they had music in the operating room and it was a lovely experience that way. I did feel some discomfort at times but only for seconds. Need to go back for cataract surgery as my eye is still blurry after the procedure. It will be over before you know it …the procedure took them about 50 minutes. Went home right after but the post operation checkup next few days to get the pressure checked. Mine was high so they zapped a few stitches on the bleb. Good luck!

Glyndebourne profile image
Glyndebourne in reply to Moultrey

Thank you! I thought heart surgery was bad enough but now strangely this feels more scary. I know it’s not always successful and I’m terrified of losing my sight as my glaucoma was diagnosed so late. I’ve been told the trab won’t improve my sight but hopefully it will stop it deteriorating further 🤞🤞🤞 Thanks again 🙏

Cnut profile image
Cnut

Hello,

I agree with all the previous responses. I had a trabeculectomy a few years ago and I am very grateful for it. I too am a musician. It has taken me a while to work out which glasses and combinations of glasses work best. I have opted for varifocal lenses and a pair of reading glasses over them if needed. This seems to be how I am able to read a score, watch a band and when I play, manage my stance. Pupils have enjoyed my two glasses approach! Good lighting and positioning of a score has also been helpful.

Wishing you all the best,

Cnut

Glyndebourne profile image
Glyndebourne in reply to Cnut

Thank you so much for your reply. I’ve been worrying about the glasses situation, as I gather it takes a while for your eyes to settle down. I’m also concerned about how much time I’ll need off work, as I missed the whole of the Spring term due to recovery from OHS. Fortunately I was able to resume teaching in the summer term, but because I need surgery on both eyes, I’m not sure how long it will be before I’ll be able to return to work. My school has been very supportive so far!

Cnut profile image
Cnut in reply to Glyndebourne

Hello again,

I do hope all goes well. I was nervous but all the staff were so kind, positive and supportive. I was anxious but given a diazepam which was calming but I am not sure I really needed it because I like to be aware of my senses. I had a local anaesthetic and the staff involved in the trab. were chatting with me throughout the procedure. It was over before I had realised it was.

I had two weeks away from working plus a half term before the operation. My sight was blurry but work was manageable and pupils were interested and intrigued. I got frustrated with playing wrong notes but once the sight had settled, and the length of time for this seems to be determined by each person’s body, I was able to have an eye test and a prescription to accommodate my vision. Hopefully I now make less sight reading mistakes! Knowledge of keys was helpful 😂

Best wishes,

Cnut

Glyndebourne profile image
Glyndebourne in reply to Cnut

Hello again! Thank you for sharing your experience with a local. Hope it’s the same for me! My students often laugh at my mistakes when I accompany them on the piano, but at least now I have a good excuse! 🤣

Cnut profile image
Cnut in reply to Glyndebourne

We can get away with all sorts if it is in time 😄

Lovearoastdinner profile image
Lovearoastdinner

Hello. I had my Trabeculectomy surgery on 5th June. I had local anaesthetic which involved eye drops in waiting area and two injections by anaesthetist in theatre. A very nice nurse held my hand all the way through. Op took a good 50 mins. Could hear surgeon, and there was a bright light, but did not feel anything. I had a lot of drops to administer afterwards Steroid was every 2 hrs for 1 month. Anti biotic 4 times a day for 1 month. This had to be kept in fridge.

Vision was blurred for most of the time drops going in. Then had to use Atropine for 2 weeks as pressure low. Pupil dilated, so vision compromised again.

However, you must follow consultant advice. For me no lifting bending, driving (due to blurryness) or getting eye wet and def no touching/rubbing eye.

I am 8 weeks down line. Seeing consultant this Thurs and hope I'll be able to resume some activities. Good luck when you go in Sept.

Glyndebourne profile image
Glyndebourne in reply to Lovearoastdinner

Thank you so much. Good luck with your ongoing recovery 🙏

RobMitchell profile image
RobMitchell

Hi,

I’m 52 and in a similar situation.

I had my trabeculectomy in my left eye in late May this year. I had a local and I will also have a local when I have my right eye done later this year.

It’s actually ok. I didn’t feel any pain at all with the surgery. It’s a bit uncomfortable and mine took about 90 mins, which was longer than I was expecting, but generally, it’s alright. The thought of it was worse than the actual procedure. The healing was painful at times but manageable.

I think my only advice would be that you probably need to be clear to your consultant that the timescale for your second trabeculectomy is for you to dictate and it depends on your recovery time. Two months on from my first op, I am absolutely not ready for the second. My sight is still very blurred in the operated eye and therefore the time isn’t right just yet.

Good luck.

Glyndebourne profile image
Glyndebourne in reply to RobMitchell

Thank you so much. My surgeon said he wanted to do my right eye 4 weeks after my left. I got the impression I didn’t have a choice in the matter! I suppose I’ll just have to wait and see how it goes. Thank you for sharing your experience. I really appreciate it 🙏

Mitziecat profile image
Mitziecat

Hi. I also have advanced glaucoma in both eyes and understand your anxiety. I have had a trabeculectomy in both eyes under local anaesthetic and it was ok. The recovery process was as mentioned in the other replies and it is important to follow the advice given. Good luck with the surgery and please let us know how you get on.

Glyndebourne profile image
Glyndebourne in reply to Mitziecat

Thank you so much. I am really grateful to all the replies I’ve had. You are all amazing 🙏

Biffo72 profile image
Biffo72

I had a trab a couple of years ago. Rest assured the procedure under a local is completely painless. The only thing you are aware of is a bright light during the op. Good luck.

Glyndebourne profile image
Glyndebourne in reply to Biffo72

Thank you so much. That’s very comforting! 🙂

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