Postoperative Care After a Trabeculectomy: What You Can Do and How to Ensure a Smooth Recovery
Trabeculectomy is a surgical procedure used to treat glaucoma by creating a new drainage pathway for intraocular fluid to lower intraocular pressure (IOP). Since glaucoma is a chronic condition that can lead to vision loss if left untreated, this procedure is often recommended when medications and laser treatments fail to adequately control eye pressure.
The recovery period after a trabeculectomy is crucial for ensuring a successful outcome. Proper postoperative care helps to minimize complications such as infection, scarring, or failure of the new drainage system. This guide provides a detailed overview of what you can do after a trabeculectomy, including aftercare instructions for the first few weeks and long-term management.
Immediate Postoperative Care (First 24–48 Hours)
What to Expect After Surgery
• Vision in the operated eye may be blurry or hazy due to swelling and medications used during surgery. This typically improves in the coming weeks.
• The eye may feel irritated, scratchy, or uncomfortable, but severe pain is unusual. Mild discomfort can usually be managed with over-the-counter pain relievers like acetaminophen.
• There may be mild redness or tearing. Some patients also experience sensitivity to light.
• A protective shield or patch is usually placed over the eye immediately after surgery to prevent accidental rubbing or pressure.
Activity Restrictions
• Avoid rubbing or touching the eye.
• Keep the eye shield on while sleeping for at least the first week to prevent unintentional pressure on the eye.
• Limit physical activity. Avoid strenuous exercises, bending over, heavy lifting, and sudden head movements that could increase eye pressure.
• Do not drive until your doctor gives approval, usually after the first follow-up visit.
• Avoid watching too much TV or using screens excessively, as this may cause eye strain.
Medication Management
• You will be prescribed antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation. These must be used exactly as instructed.
• Your doctor may prescribe additional medications, such as pupil-dilating drops or steroids, depending on your individual healing progress.
• Avoid non-prescribed eye drops, including over-the-counter artificial tears, unless your doctor approves them.
Hygiene and Eye Protection
• Keep the eye area clean, but avoid getting water or soap directly into the eye.
• Do not wear eye makeup or use facial creams near the surgical site for at least two weeks.
• Avoid exposure to dust, smoke, or strong winds, as these can irritate the eye.
• Always wear sunglasses when outdoors to protect the eye from bright light and wind.
Follow-Up Appointment
• Your first postoperative check-up is usually scheduled within 24 to 48 hours after surgery. Your doctor will examine the eye, check eye pressure, and ensure that the new drainage system is functioning properly.
Week 1 Post-Surgery
During the first week after surgery, your eye will still be healing, and it is essential to continue following your doctor’s instructions carefully.
What You Can Do
• Resume light activities such as walking, reading for short periods, and watching TV in moderation.
• If your doctor permits, you can shower, but keep water and soap away from the operated eye.
• You may begin using artificial tears if approved by your doctor to relieve dryness or irritation.
Activity Restrictions to Follow
• Avoid bending over, as this increases eye pressure and may affect healing.
• Continue avoiding heavy lifting or any physical strain.
• Do not sleep on the side of the operated eye.
• Avoid swimming pools, saunas, or hot tubs to reduce the risk of infection.
Medication and Eye Drops
• Continue using prescribed eye drops according to the schedule. Your doctor may adjust the dosage based on your healing progress.
• If you take oral medications for glaucoma, follow your doctor’s instructions on whether to continue them after surgery.
Signs of Complications to Watch For
• Increased redness, swelling, or severe pain.
• Sudden decrease in vision or worsening blurriness.
• Pus or unusual discharge from the eye.
• A visible change in the appearance of the bleb (the fluid-filled area created by surgery).
If you experience any of these symptoms, contact your ophthalmologist immediately.
Weeks 2 and 3 Post-Surgery
By the second and third weeks, your eye will be well into the healing process, but precautions are still necessary.
What You Can Resume
• Light household chores, reading, and using electronic devices in moderation.
• Some forms of gentle exercise, such as walking, if your doctor approves.
• You may start wearing glasses if needed, but avoid contact lenses until your doctor clears you.
Continued Restrictions
• Heavy lifting, vigorous exercise, and activities that increase intraocular pressure should still be avoided.
• Continue sleeping on your back or on the non-operated side.
• Do not resume wearing eye makeup until at least four weeks post-surgery.
Eye Drop Adjustments
• Your doctor may start tapering your anti-inflammatory drops based on your progress.
• If you have been on oral glaucoma medications, adjustments may be made depending on your eye pressure readings.
Follow-Up Appointments
• You will have another follow-up visit during this period. Your doctor will evaluate the healing process and may perform additional tests, such as checking intraocular pressure and assessing the bleb.
Long-Term Care After a Trabeculectomy
Healing continues for several months after trabeculectomy, and ongoing care is crucial for maintaining successful outcomes.
Lifestyle and Activity Adjustments
• Most patients can return to normal daily activities after about a month, but strenuous activities should be resumed only after clearance from the doctor.
• If you engage in high-impact sports or activities, discuss protective measures with your ophthalmologist.
Eye Examinations and Monitoring
• Regular follow-up visits are necessary to monitor intraocular pressure and the function of the bleb.
• Your doctor may adjust medications based on your eye pressure readings.
Signs of Long-Term Complications
• If you notice changes in vision, increased discomfort, or a return of high eye pressure, seek medical advice promptly.
• Some patients may require additional procedures if scarring affects the drainage function of the bleb.
Protecting Your Eye Health
• Continue protecting your eyes from harsh environments by wearing sunglasses and avoiding potential irritants.
• If your doctor permits, you can resume using artificial tears to keep your eyes comfortable.
Conclusion
Trabeculectomy is an effective surgery for managing glaucoma, but proper postoperative care is essential for ensuring a successful recovery. In the first few weeks, following medication schedules, avoiding strenuous activities, and protecting the eye from injury or infection are critical. Long-term follow-ups help to monitor intraocular pressure and maintain the function of the bleb.
By adhering to these care guidelines, you can maximize the benefits of the surgery and reduce the risk of complications. Always consult your ophthalmologist if you have concerns or experience unusual symptoms.