Abstract

Trabeculectomy remains a cornerstone in the surgical management of glaucoma till date. This abstract reviews critical pre-operative and intra-operative considerations essential for optimizing its surgical outcomes and minimizing complications.

Pre-operative assessment plays a pivotal role in patient selection and surgical planning. Determining the type and severity of glaucoma, evaluating potential risk factors and ensuring patient suitability for surgery can significantly influence the surgical results. Detailed evaluation of patients’ demography and their systemic and ocular profile can guide in surgical decision-making. Additionally, understanding of the limbal anatomy and assessment and management of systemic comorbidities can help to mitigate risks. Attention to all medical management pre-operatively, aiming to stabilize intraocular pressure and optimize the ocular surface health is essential.

Intra-operatively, a meticulous surgical technique is of paramount importance. Appropriate anaesthesia ensures patient comfort while precise conjunctival and scleral dissection facilitates creation of a functional filtering bleb. Adjunctive measures such as antimetabolite use and releasable sutures, tailored to individual patient characteristics, can balance efficacy with safety.

In conclusion, a successful trabeculectomy necessitates a thorough understanding of pre-operative patient assessment, thoughtful decision-making and a meticulous surgical technique. By addressing individualized risk factors, the trabeculectomy surgical success rates can be enhanced with improved long-term management of glaucoma patients