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Glaucoma is a group of diseases that lead to the loss of retinal ganglion cells and damage to the optic nerve with associated visual function loss. The primary risk factor is elevated intraocular pressure and therapy is directed toward lowering the pressure through medical and surgical interventions. The Trabectome(trademark) is a novel device used to remove a portion of the trabecular meshwork and inner layer of Schlemm's canal within the anterior chamber to allow for increased aqueous outflow. It is similar to trabeculotomy, with the primary difference being the permanent ablation and removal of trabecular meshwork tissue rather than a simple incision through this tissue. It offers a safer and more efficient procedure than the current gold standard, filtering surgery, while still providing reduction of intraocular pressure without reports of vision-threatening complications. Therefore, it can be offered earlier in patient management, as well as in conjunction with cataract extraction. Trabeculotomy was previously only reserved for treatment of congenital glaucoma, but the Trabectome has demonstrated its effectiveness in adults with open-angle glaucoma.
B.A. Francis. Doheny Eye Institute, 1450 San Pablo Street, Los Angeles, CA 90033, United States. bfrancis@doheny.org
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)