Home ServicesGlaucoma Care & Trabeculectomy Surgeries

Surgical SpecialityTripura's 1st NABH Hospital

Glaucoma Care & Trabeculectomy Surgeries

Tripura's premier glaucoma unit: Humphrey visual field testing, OCT RNFL scanning, laser iridotomy & microsurgical trabeculectomy.

Duration

30 - 45 Minutes (Surgery) / 10 Mins (Laser)

Anesthesia

Peribulbar Local Block / Topical Drop Anesthesia

Hospital Stay

Day-Care Outpatient (Discharge in 2-3 Hours)

Recovery

1 to 2 Weeks (Surgery) / Immediate (Laser)

Book Consultation via WhatsApp Call: +91 92336 17885

Glaucoma Care & Trabeculectomy Surgeries at Ashvini Netralaya Agartala

Detailed Medical Guide

Clinical Overview & Treatment Method

Glaucoma is often termed the 'Silent Thief of Sight' because it causes gradual, irreversible destruction of the optic nerve fibers—usually driven by elevated intraocular pressure (IOP)—without causing pain, redness, or early symptoms. Peripheral side vision is lost first, and by the time patients notice tunnel vision, significant irreversible blindness has already occurred.

At Ashvini Netralaya, our specialized Glaucoma Care Unit is dedicated to early detection, long-term disease monitoring, and advanced pressure reduction. We utilize gold-standard Humphrey automated visual field perimetry, Zeiss Cirrus HD-OCT retinal nerve fiber layer (RNFL) mapping, central corneal pachymetry, and gonioscopy. When topical hypotensive eye drops fail to halt progression, our glaucoma surgeons perform micro-surgical Trabeculectomy with Mitomycin-C, Glaucoma Drainage Implants (Ahmed Valves), and non-invasive laser treatments (SLT / YAG PI) to permanently protect your sight.

Key Clinical Advantages at Ashvini Netralaya

Tripura’s most advanced diagnostic armamentarium for early glaucoma diagnosis

Humphrey Visual Field Analyzer (HFA3) detecting microscopic blind spots (scotomas)

Zeiss Cirrus HD-OCT RNFL thickness analysis monitoring optic nerve changes over time

Micro-incisional Trabeculectomy with anti-fibrotic agents ensuring long-term filtering bleb survival

Glaucoma drainage devices (Ahmed Glaucoma Valve) for refractory or post-surgical cases

Preventive YAG peripheral iridotomy protecting narrow-angle eyes from sudden blinding attacks

Symptoms & When to Consult an Eye Specialist

If you or your family members in Agartala or Tripura experience any of the following indications, we strongly advise scheduling an evaluation:

Gradual loss of peripheral (side) vision with 'tunnel vision' effect

Severe eye pain, headache, nausea, and vomiting (in acute angle-closure glaucoma)

Seeing rainbow-colored halos around bright lights and bulbs

Frequent changes in spectacle prescription without satisfactory clarity

Difficulty adjusting vision in dark rooms or cinema halls

Having a first-degree relative (parent or sibling) diagnosed with glaucoma

Who is an Ideal Candidate for this Procedure?

Patients with chronically elevated intraocular pressure (> 21 mmHg) unresponsive to medications

Individuals showing progressive optic nerve cupping or RNFL thinning on OCT scans

Patients experiencing visual field loss despite using multiple anti-glaucoma eye drops

Patients with primary open-angle glaucoma, closed-angle glaucoma, or pseudoexfoliation

Patients with non-compliance or severe allergic reactions to chronic eye drop regimens

Options & Technology

Glaucoma Management Approaches at Ashvini Netralaya

Treatment is customized according to whether glaucoma is open-angle or closed-angle, and the stage of optic nerve damage.

Option / Type	Vision Range	Night Glare	Spectacle Freedom	Ideal Candidate
Topical Hypotensive Drops First-Line Medical	Preserves existing vision; does not restore lost vision	None (some drops cause mild conjunctival redness)	Must be instilled every day strictly on schedule	Mild to moderate open-angle glaucoma, ocular hypertension
YAG Laser Iridotomy (LPI) Preventive Laser	Relieves narrow-angle pupil block immediately	Rare temporary stray light line	One-time 5-minute laser; avoids emergency surgery	Narrow angles, acute angle-closure glaucoma attack prevention
Trabeculectomy Surgery Gold Standard Surgery	Significantly lowers IOP to protect remaining nerve fibers	None caused by procedure	Frequently eliminates need for multiple daily eye drops	Advanced glaucoma, uncontrolled IOP despite maximum drops
Ahmed Glaucoma Valve (GDD) Complex Case Solution	Self-regulating pressure relief mechanism	None	Long-term pressure reduction	Refractory glaucoma, neovascular glaucoma, failed previous surgery

Clinical Walkthrough

Step-by-Step Procedure at Ashvini Netralaya

Conducted in our modular NABH-accredited operating theatres or diagnostic laboratories with zero-infection sterilization protocols.

Pre-Operative Target IOP Determination

20 mins

Comprehensive review of 24-hour diurnal pressure curves, visual fields, and target pressure goals to prevent further nerve damage.

Peribulbar Anesthesia

10 mins

Localized numbing block ensures zero sensation and steady eye positioning throughout the microsurgery.

Conjunctival Flap & Scleral Tunnel Creation

10 mins

A partial-thickness protective scleral flap is dissected under high-magnification surgical stereomicroscopy.

Trabeculectomy & Peripheral Iridectomy

15 mins

A microscopic block of trabecular meshwork is removed, and a small peripheral opening in the iris is made to prevent blockage.

Anti-Fibrotic Application & Suture Closure

10 mins

Mitomycin-C is applied to prevent scar tissue formation, and the scleral flap is sutured with adjustable tension to create a permanent drainage bleb.

Post-Op Healing

Recovery Timeline & Visual Milestones

Days 1 to 5 Post-Surgery

Filtering Bleb Formation & Monitoring

Vision may be slightly blurry as the newly created drainage channel stabilizes. Intraocular pressure is closely monitored in the OPD.

Rest quietly at home
Instill intensive steroid and antibiotic drops
Wear protective shield at night

Weeks 2 to 4

Bleb Stabilization & Suture Adjustment

Surgeon may perform gentle massage or suture lysis if needed to achieve the perfect target pressure (usually 10-14 mmHg).

Light desk work and walking permitted
Avoid bending down, straining, or lifting heavy objects (> 5 kg)

Month 2 Onwards

Long-Term Pressure Stabilization

Drainage bleb is mature and quietly functioning under the upper eyelid. Repeat visual field test is performed to establish baseline.

Normal daily living resumed
Routine IOP check every 3 to 4 months
Annual visual field test

Pre-Procedure Preparation

•Continue all prescribed anti-glaucoma eye drops right up to the morning of surgery unless specifically stopped by your surgeon.
•Inform the doctor if you are taking blood thinners (aspirin, clopidogrel, warfarin).
•Maintain 4-6 hours of fasting prior to scheduled surgery under local block.
•Do not rub your eyes or squeeze your eyelids forcefully.
•Bring all previous Humphrey visual field reports and OCT scans for comparison.

Post-Procedure Guidelines

•Do NOT press on your eyeball or rub your eye under any circumstances.
•Avoid coughing, sneezing forcefully, straining during bowel movements, or bending from the waist.
•Do not let unboiled tap water touch the operated eye for 2 weeks.
•Wear your eye shield every night during sleep for the first month.
•Report immediately if you notice severe throbbing pain, sudden vision drop, or heavy discharge.

Precision Equipment & Technological Advantage

Humphrey Field Analyzer 3 (HFA3)

Carl Zeiss Meditec (Germany)

Equipped with SITA Faster software and Guided Progression Analysis (GPA) to objectively track glaucoma progression with unmatched reproducibility.

Cirrus HD-OCT RNFL & Ganglion Cell Complex

Carl Zeiss Meditec (Germany)

Measures retinal nerve fiber layer thickness with micron-level precision, detecting structural damage years before functional vision loss occurs.

“My eye pressure was dangerously high at 34 mmHg and 3 different eye drops weren't helping. Dr. Paruldeep performed a trabeculectomy at Ashvini Netralaya. My pressure has remained steady at 12 mmHg for over a year now, with zero eye drops! I can live without fear of going blind.”

Haradhan Bhowmik, 62Melaghar, Sepahijala District • Trabeculectomy with Mitomycin-C (IOP stabilized at 12 mmHg)

Frequently Asked Questions About Glaucoma Care & Trabeculectomy Surgeries

Can glaucoma surgery restore lost vision?

No. Vision lost to glaucoma nerve damage cannot be restored by surgery or medications. The primary purpose of trabeculectomy or laser therapy is to significantly lower eye pressure to protect and preserve your remaining vision for the rest of your life.

How do I know if I have glaucoma if there is no pain?

Because open-angle glaucoma causes no pain or early symptoms, the ONLY way to detect it is through routine annual eye checkups that include non-contact tonometry (eye pressure test) and dilated optic nerve examination.

Will I still need eye drops after glaucoma surgery?

In a majority of successful trabeculectomy surgeries, patients achieve excellent target pressure without needing any anti-glaucoma eye drops. However, some patients with advanced disease may still require a single mild drop long-term.

What is normal intraocular pressure (IOP)?

Normal intraocular pressure typically ranges between 10 mmHg and 21 mmHg. However, 'normal-tension glaucoma' can occur even within normal pressure ranges, making optic nerve imaging and visual field testing critical.

Is glaucoma hereditary?

Yes, family history is a major risk factor. If your parents or siblings have glaucoma, your risk is 4 to 9 times higher. All direct relatives of glaucoma patients should be screened annually.

What is YAG Laser Iridotomy and is it painful?

YAG Laser Iridotomy is a 5-minute, needle-free outpatient laser procedure that creates a microscopic bypass hole in the iris to prevent dangerous angle-closure attacks. The eye is numbed with drops, making the procedure virtually painless.

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