Mechanism of Action
Trabeculectomy is an incisional procedure in which a fistula is created between the anterior chamber and the subconjunctival space, bypassing the normal aqueous outflow pathway. This procedure was initially performed as a full-thickness (“unguarded”) procedure. High complication rates related to hypotony led to a major evolution in the surgical technique in that the fistula is now created under a partial-thickness flap of sclera (“guarding” the flow of aqueous) as a means of providing some resistance to aqueous flow through the fistula, thereby lowering the risk of postoperative hypotony.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.