Intraocular pressure
Target IOP is not achieved with maximally tolerated therapy. A lower target IOP is required in advanced glaucoma. Laser treatment has not produced sufficient and durable pressure reduction.
About the service
Trabeculectomy creates an additional route for aqueous outflow to lower eye pressure. It is planned for glaucoma according to target pressure, progression risk and healing considerations.
Who the service is for
Optic nerve
Visual field or optic nerve damage progresses despite treatment.
Eye-drop tolerability
Drops are poorly tolerated or do not provide reliable control of progression risk.
Cataract and lens condition
Glaucoma and cataract coexist and a combined procedure is being considered.
Choosing the surgical approach
Trabeculectomy is intraocular surgery and carries a risk of intraoperative and postoperative complications.
Lens contact with water
Depending on the clinical situation, additional treatment may be required, including laser suture lysis, injections of medication into the filtering bleb area, bleb revision, resumption of pressure-lowering medication or repeat glaucoma surgery.
Determining the mechanism of glaucoma
Bring tonometry, gonioscopy, visual-field, optic nerve/RNFL OCT and pachymetry results and previous treatment records. Do not stop glaucoma drops, anticoagulants or systemic medicines on your own.
Cataract and lens condition
Before surgery, the doctor reviews the ocular surface and conjunctiva, previous operations, inflammation, injuries, cataract, systemic conditions and medicines that may affect bleeding or healing.
When urgent care is needed
Patients should seek immediate medical attention for severe pain, sudden loss of visual acuity, marked eye redness, purulent discharge or other warning symptoms specified by their surgeon.
Limitations and safety
Trabeculectomy is an intraocular surgical procedure and carries a risk of intraoperative and postoperative complications. Possible complications include hypotony or insufficient reduction in intraocular pressure, a shallow anterior chamber, excessive filtration of aqueous humour from the filtering bleb, inflammatory reactions, intraocular haemorrhage, choroidal detachment, cataract progression, scarring of the filtering bleb and infectious complications.
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Stages
Stage 1
Preoperative assessment
The doctor assesses glaucoma type and stage, target pressure and surgical risk.
Stage 2
Preparation and anaesthesia
Preparation and anaesthesia according to the KazRIED protocol.
Stage 3
Scleral flap creation
Conjunctival access and creation of a partial-thickness scleral flap.
Stage 4
Aqueous outflow pathway
Controlled entry into the anterior chamber and creation of a filtration pathway.
Stage 5
Additional measures
Peripheral iridectomy and an antifibrotic strategy when indicated.
Stage 6
Completing surgery
Fixation of the scleral flap, watertight conjunctival closure and initial filtration assessment.
Stage 7
Postoperative review
Postoperative reviews of IOP and bleb function with management adjusted to healing.
Service benefits
A new route for fluid drainage
Trabeculectomy creates an additional route for aqueous fluid drainage to lower pressure.
A focus on target pressure
The surgical approach is selected according to the pressure needed to protect the individual optic nerve.
An option to combine cataract treatment
When indicated, the doctor may consider a combined surgical approach for glaucoma and cataract.
Managing the postoperative outcome
Scheduled examinations allow healing and pressure to be monitored and treatment adjusted when needed.
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The surgeon will review target IOP, rate of progression, visual fields, optic nerve OCT, tolerance of drops, response to laser treatment and conjunctival status, then determine whether trabeculectomy or another operation is more appropriate.
Procedure prices
Service name
Price
Trabeculectomy, (per eye)
from 247 000 ₸
Trabeculectomy + Glautex, (per eye)
from 535 000 ₸
Trabeculectomy + Repegel, (per eye)
from 328 000 ₸
Phaco + trabeculectomy, (per eye)
from 496 000 ₸
Pre/postoperative ophthalmologist monitoring, (per consultation)
from 32 500 ₸
Surgical bed-day, (per bed-day)
from 19 500 ₸
Baerveldt implant, (per item)
from 679 000 ₸
Our doctors
A team of experienced doctors across specialties.
Experience: 26 years
Head
Zhakybekov Ruslan Adilovich
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 31 years
Head
Zhurgumbaeva Gulnar Kayratovna
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 32 years
Sabyrbaev Nurlan Berdauletovich
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 26 years
Ophthalmologist
Tuletova Aygerim Serikbaevna
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 13 years
Ophthalmologist
Kalshabekov Alibi Sembaevich
Highest-category ophthalmologist
Experience: 12 years
Ophthalmologist
Tadzhimetov Murat Mikhaylovich
Highest-category ophthalmologist
Experience: 17 years
Ophthalmologist
Tokymbaeva Zhenisgul Nurmankyzy
Highest-category ophthalmologist
Experience: 10 years
Ophthalmologist
Qyryqbaev Dastan Rakhmetollauly
First-category ophthalmologist
Experience: 6 years
Ophthalmologist
Berikbay Gulzat Talghatqyzy
Second-category ophthalmologist
Experience: 6 years
Head
Dostangaliev Eset Marinuly
Second-category ophthalmologist
Trabeculectomy: how it works and treatment goals
Trabeculectomy is a filtering procedure for glaucoma. During surgery, the surgeon creates a new controlled pathway for aqueous humor to drain beneath the conjunctiva.
How is the operation performed?
The surgeon creates a partial-thickness scleral flap and an opening into the anterior chamber, allowing aqueous humor to drain into the subconjunctival space. A filtering bleb forms over the filtration site.
Why is postoperative monitoring important?
The outcome depends on both surgical technique and tissue healing. Excessive scarring can reduce filtration, making postoperative examinations an essential part of treatment.
In selected cases, the surgeon may use anti-scarring medications or drainage materials. The specific approach is determined individually.
When is trabeculectomy considered?
Trabeculectomy is considered when the required intraocular pressure (IOP) level and the risk of progression justify filtering surgery.
Depending on the clinical situation, laser treatment, nonpenetrating deep sclerectomy (NPDS), a glaucoma drainage device, or combined surgery with cataract removal may be more appropriate.
For patients with both glaucoma and cataract, KazRIED lists cataract phacoemulsification combined with trabeculectomy as a separate tariff item.
How is the outcome assessed?
The operation does not restore visual field that has already been lost. Its purpose is to reduce the risk of further glaucoma progression.
The main measure of success is safely lowering IOP to an individualized target and preserving the remaining optic nerve function over time. Sharper vision the next day is not the primary measure of surgical effectiveness.
Facts and offers
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Related services
Frequently asked questions
What is trabeculectomy?
Trabeculectomy is a filtering glaucoma operation that creates a new pathway for aqueous humour to drain from the anterior chamber beneath the conjunctiva. Its aim is to lower intraocular pressure and reduce the risk of further optic-nerve damage.
When is trabeculectomy considered?
It may be considered when target IOP cannot be achieved with other treatment, glaucoma continues to progress or substantial and sustained pressure reduction is needed to preserve vision.
Does trabeculectomy restore vision already lost to glaucoma?
No. Optic-nerve damage already caused by glaucoma is generally irreversible. Surgery aims to lower IOP and preserve remaining visual function.
Is trabeculectomy only used for open-angle glaucoma?
No. It is commonly used for open-angle glaucoma but can also be used in other forms when an appropriate degree of IOP reduction is required. Selection depends on glaucoma mechanism, ocular anatomy and previous treatment.
Must eye drops and laser always be tried first?
Not always. Less invasive treatments are often used before surgery, but earlier surgery may be appropriate in advanced or rapidly progressing glaucoma or when the risk of sight loss is high.
How does trabeculectomy differ from SLT?
SLT uses laser treatment of the trabecular meshwork to improve natural aqueous outflow. Trabeculectomy surgically creates a new filtration pathway that bypasses the natural drainage system.
How does trabeculectomy differ from nonpenetrating deep sclerectomy?
Trabeculectomy creates a controlled communication with the anterior chamber. Nonpenetrating deep sclerectomy preserves a thin trabeculo-Descemet membrane without directly entering the anterior chamber. Their efficacy and risk profiles differ.
What is a filtering bleb?
It is the subconjunctival area into which aqueous humour drains through the surgically created pathway. The fluid is then absorbed by surrounding tissues. Bleb function influences the effectiveness of the operation.
Why does conjunctival condition matter in trabeculectomy?
Postoperative scarring can reduce filtration and raise IOP. Previous surgery, inflammation and significant conjunctival scarring can influence surgical site, technique and the likelihood of sustained bleb function.
Is mitomycin C used during trabeculectomy?
Mitomycin C may be used as an antifibrotic agent to reduce postoperative scarring and improve the likelihood of maintaining filtration. The surgeon determines whether and how it should be used.