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Abstract #15967 Published in IGR 2-3
New Techniques in glaucoma surgery
Brooks AMV; Gillies WEBritish Journal of Ophthalmology 2000; 84: 1339-1340
In this editorial the authors comment on the new trend of so-called non-perforating surgery and its relation to the trabecular meshwork. They give a short historical introduction including the work of Grant and the proposition by Redmond Smith to do trabeculotomy. In fact the external pendant of the trabeculotomy is the sinusotomy. Sinusotomy and trabeculotomy have been combined to produce a filtering bleb by one of the authors, some 25 years ago. Since then trabeculectomy after Cairns has become the major filtering operation. The authors comment that with non-perforating procedures the major problem has been the lack of randomized prospective case controlled trials with adequate follow-up. A paper in the BJO last year provided some data although problems like risk of perforation and frequent need for YAG laser trabeculopuncture remain. Also the criteria for success using a pressure of less than 21 mmHg was not enthusiastically accepted. It is also pointed out that there is a lack of careful studies of the trabecular meshwork relating to non-perforating procedures. A recent study in the BJO showed that perforation of the meshwork at operation is very likely even for experienced surgeons. In view of this they feel that it is wise to withhold judgement on deep sclerectomy and viscocanalostomy until more extensive clinical appraisal is available.
The Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Abrooks@medeserv.com.au
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)