reatments for glaucoma may be focused on decreasing formation of aqueous or increasing the outflow of fluid from the eye (as in the case of glaucoma filtration surgery). Trabeculectomy is a filtration surgery where an opening is created in the anterior chamber to allow for aqueous flow out of the eye through a partial-thickness scleral flap. The aqueous then flows into the subconjunctival space, creating a filtering bleb. The aqueous may then be filtered through the conjunctiva into the tear film, be absorbed by vascular/perivascular conjunctival tissues, flow through lymphatic vessels, and/or drain through the aqueous veins. Often, antifibrotic medications, such as mitomycin C or 5-fluorouracil, may be employed to prevent excessive scarring of the filtration bleb and allow for more efficacious lowering of IOP.
Wandel T, Nattis AS. Trabeculectomy. In: Rosenberg ED, Nattis A, Nattis RJ, editors. Operative dictations in ophthalmology. Cham, Switzerland: Springer International Publishing; 2017. pp. 203-5.