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MIGS allows faster return."},"complication_rate_pct":{"min":20,"max":40,"unit":"percent","qualifier":"Any early or late complication after trabeculectomy or tube shunt, including hypotony, leak, cataract; sight-threatening under 5%."},"contraindications":["Active eye or periocular infection","Uncontrolled bleeding disorder or unsafe anticoagulation interruption","Patient unable to attend frequent postoperative visits","Medically unfit for surgery or for lying flat and still","Angle-based MIGS with closed or non-visible drainage angle"],"days_in_clinic":{"min":0,"max":0,"unit":"nights","qualifier":"Usual uncomplicated incisional glaucoma surgery in adults is a same-day discharge."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":2,"max":6,"unit":"weeks","qualifier":"Light activity earlier; avoid strenuous exercise, heavy lifting, straining, swimming and eye rubbing until cleared by the surgeon."},"final_result_months":{"min":1,"max":3,"unit":"months","qualifier":"Trabeculectomy/tube surgery: pressure stabilizes and bleb matures over weeks to months; goal is pressure lowering, not better vision."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"After day-1 and week-1 checks; surgeon clears flight once eye pressure is stable and the eye is healing without complications."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":1,"max":1,"unit":"days","qualifier":"First postoperative day: eye pressure and anterior chamber check."}},{"purpose":"assessment","requirement":"routine","after":{"min":5,"max":10,"unit":"days","qualifier":"Pressure, bleb or tube position and healing review."}},{"purpose":"assessment","requirement":"routine","after":{"min":14,"max":42,"unit":"days","qualifier":"Additional visits in the first weeks; frequency depends on healing; suture adjustment or removal may occur if needed."}},{"purpose":"result_review","requirement":"routine","after":{"min":60,"max":120,"unit":"days","qualifier":"Review of long-term pressure control and medication needs."}}],"indications":["Glaucoma with intraocular pressure not controlled by medications and/or laser","Progressive nerve damage or visual field loss despite maximal therapy","Intolerance or poor adherence to glaucoma medication in selected patients","Angle-closure or secondary glaucoma uncontrolled by other measures"],"main_risks":["Hypotony (too-low eye pressure) or persistently high pressure","Bleeding in the eye or choroidal detachment","Infection of the eye, including bleb-related infection (blebitis, endophthalmitis)","Cataract development or progression","Bleb leak or scarring failure, possibly needing repeat surgery","Tube exposure, erosion or malposition (tube shunts)","Temporary or permanent vision loss, double vision or drooping eyelid"],"pain":"Usually little pain during surgery under local anesthesia (pressure sensation only); mild to moderate ache, irritation or foreign-body sensation for a few days afterwards, usually controlled with simple analgesics.","preparation":["Eye exam with pressure, visual field and optic nerve imaging","Review regular medicines with surgeon or physician","Arrange an escort home and eye shield/drops supply","Instructions on fasting only if sedation is planned","Treat ocular surface infection or inflammation beforehand if present"],"recovery_timeline":[{"phase":"Day 0-1","description":"Eye shield placed; vision blurred; first-day pressure check.","restrictions":["Do not rub or press on the eye","Keep shield on as instructed"]},{"phase":"Weeks 1-2","description":"Intensive anti-inflammatory and antibiotic drops; frequent visits; vision gradually clears.","restrictions":["Avoid bending with head down, heavy lifting and straining","Avoid water and dust exposure to the eye"]},{"phase":"Weeks 2-6","description":"Gradual return to normal activity; adjustment or tapering of drops; bleb or tube assessment.","restrictions":["Avoid strenuous exercise and swimming until cleared"]},{"phase":"Months 1-3","description":"Pressure stabilizes and healing completes; possible glasses update.","restrictions":[]}],"rehabilitation_days":{"min":14,"max":42,"unit":"days","qualifier":"Ordinary functional recovery after trabeculectomy or tube shunt; MIGS usually quicker."},"result_longevity":"Variable; pressure control may last years but depends on technique, glaucoma type and scarring, and some patients need drops or repeat surgery. Surgery slows further damage but does not restore lost vision.","revision_rate_pct":{"min":10,"max":20,"unit":"percent","qualifier":"Repeat glaucoma surgery or return to theatre within 5 years; needling in clinic is excluded."},"scars":"No visible external scar; the incision is under the upper eyelid. 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Later reviews at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that the surgeon obtains informed consent after discussing surgery’s risks, benefits, and expected outcomes","scope":"procedure","source":{"url":"https://www.aao.org/education/summary-benchmark-detail/glaucoma-summary-benchmarks-2020","host":"aao.org","quote":"Obtain informed consent from the patient or patient's surrogate decision maker after discussing the risk, benefits, and expected outcomes of surgery","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that a preoperative evaluation confirms surgery is indicated","scope":"procedure","source":{"url":"https://www.aao.org/education/summary-benchmark-detail/glaucoma-summary-benchmarks-2020","host":"aao.org","quote":"Ensure that the preoperative evaluation confirms that surgery is indicated","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that the 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check","scope":"procedure","source":{"url":"https://www.aao.org/education/summary-benchmark-detail/glaucoma-summary-benchmarks-2020","host":"aao.org","quote":"Perform at least one IOP check immediately prior to surgery and within 30 minutes to 2 hours after surgery","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An offer proposes surgery without confirming that preoperative evaluation shows surgery is indicated","scope":"procedure","source":{"url":"https://www.aao.org/education/summary-benchmark-detail/glaucoma-summary-benchmarks-2020","host":"aao.org","quote":"Ensure that the preoperative evaluation confirms that surgery is indicated","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"A surgeon does not discuss surgery’s risks, benefits, and expected outcomes before asking for consent","scope":"procedure","source":{"url":"https://www.aao.org/education/summary-benchmark-detail/glaucoma-summary-benchmarks-2020","host":"aao.org","quote":"Obtain informed consent from the patient or patient's surrogate decision maker after discussing the risk, benefits, and expected outcomes of surgery","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"A clinic offers treatment without an eye examination to determine what treatment is right for you","scope":"procedure","source":{"url":"https://www.aao.org/eye-health/treatments/combined-cataract-glaucoma-surgery-facts","host":"aao.org","quote":"To find out what treatment is right for you, your ophthalmologist will examine your eyes.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Red, painful eye","urgency":"contact_clinic","general":false,"source":{"url":"https://www.aao.org/eye-health/diseases/trabeculectomy-12","host":"aao.org","quote":"Call your ophthalmologist immediately if your eye is red, painful or just does not feel right.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Eye redness with discharge","urgency":"emergency","general":false,"source":{"url":"https://www.aao.org/eyenet/article/endophthalmitis-after-glaucoma-surgery","host":"aao.org","quote":"Patients should be instructed to seek care immediately if ocular redness, pain, discharge, or decreased vision develops.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"Decreased vision after surgery","urgency":"emergency","general":false,"source":{"url":"https://www.aao.org/eyenet/article/endophthalmitis-after-glaucoma-surgery","host":"aao.org","quote":"Patients should be instructed to seek care immediately if ocular redness, pain, 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