Treatment Overview
Blebless Trabeculectomy Technique in Korea is a modern evolution of traditional trabeculectomy designed to lower intraocular pressure (IOP) without forming a large, prominent conjunctival bleb. Instead of creating an external filtration reservoir, this technique enhances internal outflow pathways, reduces dependence on bleb formation, and minimizes complications associated with bleb leaks, blebitis, or long-term bleb instability.
Korean glaucoma centers utilize advanced OCT-guided dissection, AI-based fluid dynamics planning, and micro-precision scleral techniques to optimize internal drainage and achieve stable IOP reduction—making blebless trabeculectomy one of the safest and most predictable filtration surgeries available today.
Purpose & Benefits
Purpose
- Lower intraocular pressure without relying on a traditional bleb.
- Enhance the natural outflow pathways through internal filtration.
- Reduce long-term bleb-related risks seen in standard trabeculectomy.
- Provide a safer alternative for patients with scarring or conjunctival limitations.
Benefits
- No External Bleb: Eliminates risk of bleb leaks, infections, and thin-walled blebs.
- Low Complication Profile: Safer than conventional trabeculectomy.
- Faster Recovery: Less conjunctival disruption and inflammation.
- Stable Long-Term IOP Control: Internal drainage reduces reliance on fragile blebs.
- Better Comfort: Fewer foreign-body sensations and cosmetic concerns.
- Reduced Infection Risk: No exposed bleb means minimal blebitis risk.
Ideal Candidates
Blebless Trabeculectomy in Korea is ideal for:
- Patients with primary open-angle glaucoma (POAG) seeking stable IOP reduction.
- Individuals with conjunctival scarring or conditions that make bleb formation risky.
- Patients who experienced complications from previous trabeculectomy blebs.
- Those preferring a safer, more physiological filtering method.
- Patients with moderate to advanced glaucoma needing stronger IOP control.
- Individuals who are not suitable candidates for tube shunts or full trabeculectomy.
Possible Risks & Complications
Although significantly safer, blebless trabeculectomy may still involve:
- Mild inflammation or redness
- Temporary blurred vision
- Small hyphema
- Transient pressure changes
- Rare internal scarring reducing flow
- Possibility of needing adjunctive medications later
Korean surgeons minimize these risks using intraoperative imaging, precise microsurgical tools, and postoperative fibrosis control.
Types of Blebless Trabeculectomy Approaches in Korea
Micro-Scleral Internal Filtration Technique
Creates a deep scleral flow channel without external bleb elevation.
Deep Scleral Tunnel Method
Develops an internal drainage tunnel that shunts fluid into adjacent tissues.
Viscoelastic-Assisted Internal Drainage
Viscoelastic expands internal spaces to promote smooth aqueous flow.
Hybrid Blebless + Canaloplasty
Combines internal drainage with Schlemm’s canal restoration.
Bleb-Free Trabeculectomy With Scleral Implant
Implant inserted beneath sclera to maintain internal drainage patency.
Surgical Techniques
High-Resolution OCT-Guided Planning
Maps scleral thickness and ideal drainage zones.
Deep Scleral Pocket Creation
A precise, partial-thickness scleral tunnel is created to allow controlled filtration.
Preservation of Descemet Membrane
Internal filtration occurs through natural microperforations.
Viscocanal Expansion
Enhances outflow through Schlemm’s canal or adjacent tissues.
Optional Internal Implant Placement
Supports long-term drainage without bleb formation.
AI-Guided Flow Prediction
Ensures safe and stable outflow post-surgery.
Treatment Process in Korea
Step 1 – Comprehensive Evaluation
Includes OCT, visual fields, IOP measurement, and anterior segment imaging.
Step 2 – Surgical Planning
Surgeon chooses the optimal internal drainage technique.
Step 3 – Blebless Trabeculectomy
Performed under local anesthesia with micro-precision dissection.
Step 4 – Immediate Postoperative Care
Anti-inflammatory drops given; IOP monitored closely.
Step 5 – Follow-Up Visits
Imaging ensures internal drainage spaces remain open without external bleb formation.
Treatment Duration: 25–40 minutes
Setting: Surgical center or hospital
Recovery & After-Care
After-Care Guidelines
- Use anti-inflammatory and antibiotic drops as prescribed.
- Avoid rubbing eyes or heavy physical activity for 1–2 weeks.
- Protect the eye from contaminants during healing.
- Continue glaucoma medications only if instructed.
- Attend all follow-up visits for drainage monitoring.
Recovery Timeline
- Days 1–3: Mild swelling or irritation.
- Week 1: Vision begins to improve; internal drainage establishes.
- Weeks 2–4: IOP stabilizes as tissue heals.
- Months 1–3: Long-term drainage channel fully functional.
Results & Longevity
Expected Results
- Significant IOP reduction, often comparable to standard trabeculectomy.
- No bleb-related complications.
- Faster recovery and improved comfort.
- Reduced dependency on medications.
- Stable long-term pressure control.
Longevity
- Results typically last 5–10 years or longer.
- Longevity enhanced using Korean imaging-guided internal maintenance.
- Revision is easier and safer because the conjunctiva is preserved.
Why Korea Is a Top Destination
- Expertise in bleb-free filtration surgery with internationally recognized outcomes.
- OCT and AI-assisted planning for internal drainage optimization.
- Advanced micro-surgical tools enabling precise scleral dissection.
- Lower complication rates than traditional trabeculectomy.
- Comprehensive glaucoma care including imaging, surgery, and follow-up.
Unique Korean Innovations
- AI-driven selection of internal drainage pathways.
- Hybrid blebless + MIGS or canaloplasty models.
- Customized deep scleral implants for long-term drainage.
- Real-time OCT guidance during surgery.
- Anti-fibrotic microdosing to preserve internal flow channels.
Cost Range (Indicative Estimate)
| Treatment Type | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Blebless Trabeculectomy | ₩3,000,000 – ₩5,000,000 | ~$2,300 – $3,750 | Internal filtration surgery + care |
| Blebless With Scleral Implant | ₩4,500,000 – ₩7,000,000 | ~$3,400 – $5,300 | Implant + imaging |
| Hybrid Blebless + Canaloplasty | ₩5,500,000 – ₩8,500,000 | ~$4,150 – $6,400 | Combination surgery + extended follow-up |
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul) – Leading in internal filtration and blebless techniques.
- Dream Eye Center (Seoul) – Specialists in bleb-free glaucoma surgery with rapid recovery.
- BGN Eye Clinic (Busan & Seoul) – Experts in deep scleral drainage techniques.
- Glory Seoul Eye Clinic – Known for OCT-guided internal trabeculectomy.
- K-Cure Vision Center (Gangnam) – Innovators in AI-based filtration pathway design.
