Guarded filtration
A partial-thickness scleral flap meters flow so pressure does not crash overnight.
Glaucoma Surgery
Glaucoma Surgery
Trabeculectomy
Guarded filtration surgery at Neera Eye Centre — a new drain for the eye when glaucoma needs a larger, lasting pressure drop.
Filter
New drainage pathway
Bleb
Surface reservoir under the lid
MMC
Antifibrotic to keep the drain open
Advanced
For high-risk or progressing glaucoma
Service Overview
Trabeculectomy is the classic glaucoma operation: a small trapdoor is made in the sclera so fluid can leave the eye into a bleb under the conjunctiva. It usually lowers pressure more than MIGS and is chosen for advanced field loss, very high IOP, or when stents and canal surgery will not reach the target. It needs closer after-care — bleb massage, suture adjustment, and steroid drops — because scarring can close the new drain.
What It Covers
Antifibrotic use
Mitomycin-C or 5-FU is often applied to reduce scarring of the bleb.
Suture control
Releasable or laserable sutures let the surgeon fine-tune flow after surgery.
Bleb care
Needling or extra drops if the bleb scars; infection precautions for life.
Who It Is For
Advanced or rapidly progressing glaucoma
When the nerve needs a lower target than MIGS can reliably give.
Failed drops, laser, or MIGS
Pressure still too high after medicines and less invasive surgery.
Younger patients needing a big drop
Selected after counselling about lifelong bleb care.
How It Works
Plan the target
Field, OCT, and gonioscopy set how low pressure must go and whether a bleb is justified.
Filtration surgery
Under local anaesthesia a trapdoor drain is created, usually with an antifibrotic.
Intensive follow-up
Early visits adjust sutures and drops; then long-term nerve monitoring continues.
Why Choose Trabeculectomy Here
Trabeculectomy sits beside MIGS in the same glaucoma service, so filtration is used when you need it — not as the default for every eye, and not withheld when a micro-stent would leave the nerve at risk. Follow-up is at Darya Ganj with the team who already know your fields and OCT.
Frequently Asked Questions
How is trabeculectomy different from MIGS?
Trabeculectomy builds a new drain and a bleb. MIGS uses the natural canal with smaller wounds. Trabeculectomy usually lowers pressure more and needs stricter after-care.
Will I still use drops?
Many patients use fewer drops; some still need one medicine. The aim is a safer pressure, not a guarantee of zero bottles.
Is the bleb visible?
It sits under the upper lid in most cases. You may feel a mild bulge; glasses or a hat help if the surface is sensitive.
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