Information for the parents/patients undergoing Glaucoma Surgery

Glaucoma Surgery (Trabeculotomy and Trabeculectomy)

  • As shown in the diagram, in a Glaucoma surgery in a child a hole is made to allow excess accumulation of water inside the eye (aqueous) to flow out of the eye
  • In a standard Glaucoma surgery in children, making of the hole is performed after opening up the pipeline  (Schlemm’s Canal) that blocks the drainage of the aqueous
  • This is accomplished by using specialized instruments called Harm’s Trabeculotome

Differences in performing the Glaucoma Surgery in children

  • The timing of the surgery is highly important (late surgery means poor vision)
  • The tissues in the eyes are very delicate hence require – special handling with special instruments and specialized techniques
  • The surgical procedure demands high level of skill and experience
  • Specialised instruments are required for assessment and management viz. Barkan’s Lens, Harm’s Trabeculotome and Perkin’s Tonometer
  • The surgery takes nearly 25 minutes per eye
  • There would be a bandage after surgery for 24 hours and there are no food or activity restrictions after surgery
  • The patient/child can start going to the school/routine activities a week after the surgery
  • Success rate of the Glaucoma surgery ranges from 70%-80%
  • A resurgery may be required later  for which Jyotirmay Eye Clinic takes partial responsibility and would offer appropriate reduction in charges


Anesthesia

  • Local Anesthesia: This is achieved by giving an injection near the eye. It is given a few minutes before the surgery and given very slowly so that the patient does not feel very uncomfortable. The effect of the injection lasts for 2-3 hrs
  • General Anesthesia: This is the most favored method for children or anxious adults. During the surgery, the patient is on oxygen. Pulse and blood oxygen levels are constantly monitored by a very experienced anesthetist. It is very important that the patient is starving (should not take even the sips of water) from approximately 6 hours prior to the surgery and has perfect health. This has to be certified by the physician or pediatrician. Our anesthetist takes final decision on the safety of the anesthesia administration.
  • For us safety of the child is paramount. Nevertheless, general anesthesia carries a small risk of unanticipated event and the patient / parents should know this. Certainly we will take all the precautions to ensure nothing goes wrong during or after the surgery but, biological systems are not fully predictable.
  • Common side effects of a Glaucoma surgery world over are as follows

 

Over/Under filteration                                                                                                                     15%

Shallow Anterior Chamber                                                                                                             5%

Later under filteration                                                                                                                     25%

 

  • Rare complications are many that include bleeding, infection, wrong lens power etc Very rare events of vision loss and death are also reported.

 

 

At Jyotirmay Eye Clinic we constantly work towards eliminating complications by

  1. Rigorous and multiple preoperative examinations
  2. Performing every eye surgery under microscope (-Zeiss Inc, world’s best microscope made in Germany)
  3. 3.      Performing every surgery with Hiluron injection, Specialised Instruments and High level of Skill and Determination
  4. Employing a highly competent well equipped Anesthetist
  5. Ensure fitness by obtaining Preoperative Anesthesia fitness from physicians
  6. Providing you with a very clean, safe and well equipped Operation Theatre

 

Certainly we value your trust in us. We keep our self most updated with the state of the art in medicine. We would do everything to provide you/your child with the best possible care, as would be the case if it was our own child or a relative.

We exist to serve.

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We have read this information brochure and cleared our doubts by discussing with Dr Mihir Kothari. We give consent to Dr Mihir Kothari to perform Glaucoma surgery ………………………………………………. ………………………………………..

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