Treatment Overview
Low-Tension Trabeculectomy in Korea is a specialized filtration surgery designed to achieve exceptionally low intraocular pressure (IOP) levels—often in the single digits—while maintaining safety and preventing hypotony-related complications. This approach is ideal for patients with glaucoma that continues to progress even at “normal” pressure levels, such as normal-tension glaucoma (NTG), which is highly prevalent in East Asian populations.
Korean glaucoma specialists excel in this technique by combining micro-precision flap engineering, controlled anti-scarring therapy, OCT-guided flow assessment, and AI-assisted filtration planning, ensuring stable, ultra-low-pressure outcomes without compromising ocular structure or visual acuity.
Purpose & Benefits
Purpose
- Lower IOP to extremely low target levels (often 6–10 mmHg).
- Prevent glaucoma progression in patients with normal-tension or advanced glaucoma.
- Reduce the need for multiple pressure-lowering medications.
- Provide consistent, long-term filtration in eyes requiring aggressive pressure control.
Benefits
- Effective for NTG: Ideal for Korean and East Asian populations with high NTG prevalence.
- Ultra-Low Pressure Achievable: Tailored flap tensioning enables safe pressure reduction.
- Lower Risk of Hypotony: Advanced suture titration prevents overfiltration.
- Enhanced Visual Field Preservation: Helps slow or stop progression in severe cases.
- Personalized Pressure Targeting: Optimized for each patient’s optic nerve health.
- Long-Term Stability: Diffuse bleb formation provides sustained pressure control.
Ideal Candidates
Low-Tension Trabeculectomy in Korea is ideal for:
- Patients with normal-tension glaucoma (NTG) experiencing disease progression.
- Individuals with advanced or end-stage glaucoma requiring very low IOP.
- Patients whose IOP remains too high despite maximum therapy.
- Eyes with thin corneas, where true pressure is underestimated.
- Individuals with optic nerve damage disproportionate to IOP levels.
- Patients seeking long-term, medication-independent pressure control.
Possible Risks & Complications
Although carefully controlled, potential risks include:
- Transient hypotony
- Shallow anterior chamber
- Choroidal effusion (rare and reversible)
- Mild inflammation
- Small bleb leaks
- Scar tissue formation reducing low-pressure success
Korean surgeons minimize risk through precise flap tensioning, titrated suturing, postoperative flow modulation, and advanced anti-scarring strategies.
Types of Low-Tension Trabeculectomy in Korea
Adjustable-Suture Low-Tension Trabeculectomy
Allows postoperative fine-tuning of pressure via suture modulation.
OCT-Guided Low-Tension Filtration
Uses intraoperative imaging to ensure optimal bleb formation and flap resistance.
MMC-Assisted Low-Tension Technique
Customized MMC dosing reduces fibrosis for ultra-low IOP maintenance.
Hybrid Low-Tension Filtering + Implant Enhancement
A collagen or gel implant helps maintain stable flow at low pressure.
Low-Tension Trabeculectomy for NTG
Tailored specifically for normal-tension glaucoma, focusing on optic nerve preservation.
Deep Scleral Enhancement Low-Tension Approach
Additional deep scleral dissection ensures smoother aqueous diffusion.
Surgical Techniques
AI-Based Pressure Targeting
Predicts the ideal flap architecture needed to achieve specific low-pressure goals.
Precision Scleral Flap Design
Flap thickness, length, and shape calibrated to achieve controlled low filtration.
Trabecular Block Creation
Forms the primary filtration ostium for aqueous drainage.
Titration Suturing
Adjustable sutures regulate the exact degree of flow resistance.
Targeted MMC Application
Micro-dosed to prevent fibrosis without excessive tissue thinning.
OCT-Guided Bleb Formation
Real-time imaging ensures diffuse, low-resistance bleb distribution.
Treatment Process in Korea
Step 1 – Comprehensive Evaluation
Includes visual field testing, optic nerve imaging, OCT of the anterior segment, and detailed IOP mapping.
Step 2 – Low-Pressure Surgical Planning
AI-supported models calculate flap resistance and healing behavior.
Step 3 – Low-Tension Trabeculectomy
Performed under local anesthesia with precise flap and suture design.
Step 4 – Early Postoperative Flow Regulation
Includes adjustable sutures, bleb massage, or 5-FU modulation as needed.
Step 5 – Long-Term Monitoring
Regular OCT and pressure checks ensure sustained low IOP levels.
Treatment Duration: 30–45 minutes
Setting: Hospital or outpatient glaucoma surgery unit
Recovery & After-Care
After-Care Guidelines
- Use anti-inflammatory and antibiotic drops as prescribed.
- Avoid rubbing the eye, high exertion, or face-down positions.
- Attend all follow-up visits for suture adjustment and flow assessment.
- Avoid exposure to contaminated water until tissues heal.
- Report sudden pain, vision changes, or increased redness.
Recovery Timeline
- Days 1–3: Early pressure drop and mild discomfort.
- Week 1: Flap and bleb stabilize; sutures may be adjusted.
- Weeks 2–4: IOP approaches target low-tension range.
- Months 1–3: Long-term pressure stability achieved.
Results & Longevity
Expected Results
- Achieves single-digit or low-teens IOP levels consistently.
- Improved optic nerve protection in NTG and advanced glaucoma.
- Reduced need for glaucoma medications.
- Stable, diffuse bleb architecture.
- Lower risk of progression compared to medical therapy alone.
Longevity
- Results typically last 10–20+ years.
- Korean anti-scar protocols and regular imaging extend durability.
- Adjustability during healing improves long-term low-pressure success.
Why Korea Is a Top Destination
- World leaders in normal-tension glaucoma treatment, especially for East Asian populations.
- AI-guided filtration planning for customized low-pressure targets.
- OCT-integrated surgical systems for perfect flap and bleb control.
- Exceptionally low complication rates due to precise Korean surgical protocols.
- Comprehensive glaucoma management ensuring stable long-term follow-up.
Unique Korean Innovations
- AI-based low-pressure prediction algorithms.
- Ultra-precise adjustable flap suturing systems.
- Real-time 4D OCT for bleb and flap evaluation.
- Nano-thin flow modulation implants for ultra-low IOP.
- MMC-microdose protocols tailored to NTG healing profiles.
Cost Range (Indicative Estimate)
| Procedure Type | Price (KRW) | Approx. USD | Includes |
|---|---|---|---|
| Standard Low-Tension Trabeculectomy | ₩4,000,000 – ₩6,500,000 | ~$3,000 – $4,900 | Surgery + MMC + aftercare |
| Adjustable-Suture Low-Tension Technique | ₩5,000,000 – ₩7,500,000 | ~$3,750 – $5,600 | Suture modulation + imaging |
| Hybrid Low-Tension + Implant Support | ₩6,500,000 – ₩9,000,000 | ~$4,900 – $6,750 | Implant + MMC + extended follow-up |
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul) – Experts in NTG-focused low-tension filtration.
- Dream Eye Center (Seoul) – Specialists in adjustable low-pressure trabeculectomy.
- BGN Eye Clinic (Busan & Seoul) – Leaders in hybrid low-tension glaucoma surgery.
- Glory Seoul Eye Clinic – Renowned for OCT-guided low-resistance bleb engineering.
- K-Cure Vision Center (Gangnam) – Innovators in AI-assisted low-tension surgical planning.
