Post-Operative Care and Concerns After Trabeculectomy Surgery

Q: Post-Operative Care and Concerns After Trabeculectomy Surgery

A-Han： 1. Massage is intended to ensure the channels are unobstructed; if post-surgery stability has been achieved, massage may not be necessary. 2. For the reasons mentioned above, if there are concerns, massage is also acceptable. 3. Acupuncture may help ope

Postoperative massage after a small梁 resection?

Hello Doctor, I underwent bilateral trabeculectomy in February 2019.
Postoperatively, I maintained my eye pressure around 16 with eye massages.
During my recent follow-up visit, the doctor informed me that I no longer need to massage my eyes.
Due to the high volume of patients, I couldn't ask detailed questions, but I vaguely remember the doctor mentioning that the surgical site appears very flat and that I might need a needle to reopen the channel.
I'm unsure what this means, and I think I also heard something about scarring.

1.
Could you please explain this to me? I felt hesitant to ask too many details during the appointment.

2.
Why is it no longer necessary to massage my eyes? Isn't the massage supposed to apply some pressure to help lower the eye pressure? My eye pressure today was the same as usual, and I'm concerned that stopping the massages might cause a rapid increase in pressure since my next follow-up is in three months.

3.
I read online that after trabeculectomy, young patients' wounds can easily become blocked due to good healing capacity within three years.
If I do need to undergo a needle procedure, will I have to start using a lot of medications again?
4.
I had a retinal detachment surgery three months ago due to high myopia and external trauma.
Can you tell me if there are any precautions I should take now that I am recovering well?
5.
My vision is currently adequate for normal living, and I regularly take lutein and fish oil.
Do these supplements help my eyes?
6.
How long after retinal detachment surgery can I engage in vigorous activities such as basketball, dancing, or jogging?
7.
What factors contribute to a higher risk of recurrent retinal detachment?
Thank you, Doctor, for your assistance in answering these questions.
I greatly appreciate it.

Ahan, 20~29 year old female. Ask Date: 2022/06/02

Dr. Gao Pilin reply Ophthalmology

A-Han: 1.
Massage is intended to ensure the channels are unobstructed; if post-surgery stability has been achieved, massage may not be necessary.
2.
For the reasons mentioned above, if there are concerns, massage is also acceptable.
3.
Acupuncture may help open the channels, reducing the need for multiple medications.
4.
Avoid further impact; if there are any changes or abnormalities in vision, seek examination promptly.
5.
That is possible.
6.
It depends on the degree of retinal recovery, and since the extent of damage varies among individuals, it is best to discuss with a physician.
7.
The most common cause is retinal tears induced by external forces, such as intense physical activities or impacts.

Reply Date: 2022/06/02

More Info

After undergoing trabeculectomy surgery, it is essential to understand the post-operative care and potential concerns that may arise. Trabeculectomy is a surgical procedure aimed at reducing intraocular pressure (IOP) in patients with glaucoma. Here’s a comprehensive overview addressing your questions and concerns.

1. Understanding Post-Operative Instructions: After your surgery, your doctor advised you to stop massaging your eyes. This is likely because the initial healing phase has progressed, and the need for manual pressure to maintain IOP has diminished. Massaging can sometimes lead to complications, such as increased inflammation or pressure fluctuations. The "thing" that your doctor mentioned being "flat" could refer to the filtering bleb created during the surgery, which is essential for fluid drainage. If it becomes too scarred or blocked, it may require further intervention, such as needling, to reopen the drainage pathway.

2. Concerns About IOP: It’s understandable to worry about your IOP rising after stopping the massages. However, your doctor likely believes that your eye is stable enough to maintain appropriate pressure without manual manipulation. Regular follow-ups will help monitor your IOP, and if any issues arise, your doctor can address them promptly. If you notice any significant changes in vision or discomfort, it’s crucial to contact your healthcare provider immediately.

3. Needling Procedure: If needling is required, it is typically performed in an outpatient setting and aims to reopen the drainage pathway. While it may involve some medication adjustments, it is a common procedure and can often be managed effectively. Your doctor will guide you on any necessary medications post-procedure.

4. Post-Retinal Detachment Surgery Care: Since you had retinal detachment surgery three months ago, it’s vital to continue monitoring your vision and any symptoms. Follow your doctor's advice regarding activity restrictions. Generally, after retinal surgery, patients are advised to avoid strenuous activities for several weeks to months, depending on individual healing. Always consult your ophthalmologist before resuming high-impact sports like basketball or running.

5. Nutritional Supplements: Taking supplements like lutein and fish oil can be beneficial for eye health. Lutein is known for its role in protecting the retina, while omega-3 fatty acids (found in fish oil) may help reduce inflammation and support overall eye health. However, these should complement, not replace, prescribed treatments.

6. Resuming Physical Activities: The timeline for returning to vigorous activities varies based on individual recovery. Generally, after retinal surgery, patients are advised to wait at least 4-6 weeks before engaging in high-impact sports. Your ophthalmologist will provide personalized advice based on your healing progress.

7. Risk of Retinal Detachment Recurrence: The risk factors for recurrent retinal detachment include high myopia (nearsightedness), previous detachment, and certain eye conditions. Regular follow-ups and monitoring are essential to catch any potential issues early.

In conclusion, maintaining open communication with your healthcare provider is crucial for your recovery. Don’t hesitate to ask questions during your appointments, as understanding your condition and treatment plan is vital for your peace of mind and overall health. Regular monitoring of your eye pressure and vision, along with adherence to your doctor's recommendations, will help ensure the best possible outcomes following your surgeries.

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