Trabeculotomy ab interno with internal limiting membrane forceps for open-angle glaucoma

Nakasato, Houmei; Uemoto, Riyo; Isozaki, Masaru; Meguro, Akira; Kawagoe, Tatsukata; Mizuki, Nobuhisa
June 2014
Graefe's Archive of Clinical & Experimental Ophthalmology;Jun2014, Vol. 252 Issue 6, p977
Academic Journal
Purpose: To describe a new technique to perform trabeculotomy ab interno on eyes with open-angle glaucoma (OAG). Methods: This was a retrospective study. We inserted a 25-gauge forceps that is usually used for internal limiting membrane peeling into the anterior chamber, and grasped and pulled the inner wall of Schlemm's canal away from the canal. The inner wall of Schlemm's canal was stripped for about 100° to 120° in 26 eyes of 23 patients. The intraocular pressure (IOP) and number of glaucoma medications were recorded before, and 1 day, 1 week, 2 weeks, and 1, 3, 6, 10, 12, 15, 17, 19, 24, 27, 30, and 33 months after the surgery. The intra- and postoperative complications were recorded. Results: The mean ± standard deviation of the preoperative IOP was 20.0 ± 6.8 mmHg with a range from 10 to 38 mmHg ( n = 26). The IOP was significantly reduced ( P < 0.05; paired t-tests) at 1 week, 2 weeks, and 1, 3, 6, 10, 12, 15, 17, 24, 19, 27, 30, and 33 months after the surgery. The mean preoperative number of glaucoma medications was significantly reduced ( P < 0.001; paired t-tests) at 1 week, 2 weeks, and 1, 3, 6, 10, 12, 15, 17, 19, 24, 27, 30, and 33 months after the surgery. No vision-threatening complications were found in any of the cases, but there were blood clots in the anterior chamber postoperatively in 92.3 % of the cases. Conclusions: Trabeculotomy ab interno for OAG is effective but with some minor complications. A larger number of patients with longer follow-up periods are needed to determine the long-term effectiveness of this procedure.


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