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Tube-shunt surgery (seton glaucoma surgery)
involves placing a flexible plastic tube with an attached silicone drainage
pouch in the eye to help drain fluid (aqueous humor) from
the eye. This type of surgery is usually done after a trabeculectomy that
failed. If a person already has or is likely to form scar tissue in the eye,
this type of surgery may be done at the start.
can be done with the person asleep (general anesthesia) or with anesthetic
applied only to the eye (local anesthesia).
The person does not have to be
admitted to the hospital. But children may stay in the hospital overnight
following surgery. And in some cases, your doctor may recommend that you stay
in the hospital overnight following surgery.
The person usually
sees the doctor within a day after tube-shunt surgery and 2 to 5 other times
during the 6 weeks after surgery, depending on the person's recovery.
Initially after surgery, antibiotics may be applied to the eye.
Antibiotics may also be injected under the lining of the eyelid (conjunctiva)
at the time of the surgery. At the end of surgery, the eyelid is usually
taped shut, and a hard covering (eye shield) is placed over the eye.
Corticosteroid medicines are usually applied to the eye for about 1 to 2 months
after surgery to reduce inflammation in the eye.
activity that might jar the eye needs to be avoided after surgery. For several weeks after
surgery, the person
usually needs to avoid bending, lifting, or straining.
After surgery, people who have problems with
constipation may need to take laxatives to avoid straining while trying to pass
stools. Straining can raise the pressure inside the eye. Your doctor may
suggest wearing a shield at night to avoid rubbing the eye when you
Tube-shunt surgery is most often
used for people who have had previous trabeculectomy surgery that was not
successful, usually due to scarring.
Tube-shunt surgery is also
frequently used to treat glaucoma when a person has a:
More than half of tube-shunt surgeries are successful. This surgery has been shown to reduce intraocular pressure (IOP) and the need for further glaucoma treatment.footnote 1
Complications of tube-shunt surgery that may
occur right after surgery include:
Late complications of tube-shunt surgery include:
Tube-shunt pouches are not often used as a first treatment for glaucoma.
The advantage of tube-shunt surgery for glaucoma is that there is less chance
of severe scarring that can block the drainage opening. This can be an
important consideration for people who have had prior surgery for glaucoma that
did not work. But the complications from tube-shunt surgery can be serious too.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Gedde SJ, et al. (2009). Three-year follow-up of the tube versus trabeculectomy study. American Journal of Ophthalmology,148(5): 670–84.
ByHealthwise StaffPrimary Medical ReviewerAdam Husney, MD - Family MedicineSpecialist Medical ReviewerChristopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
Current as ofSeptember 9, 2014
Current as of:
September 9, 2014
Adam Husney, MD - Family Medicine
& Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
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