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Editors Selection IGR 19-1
Surgical treatment: Minitrab
Comment by Paul Palmberg on:
15270 Mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma, Thimmarayan SK; Rao VA; Gupta A, European Journal of Ophthalmology, 2006; 16: 674-679
Thimmarayan et al. (1293) laudably have performed a prospective study to compare a 'mini-trabeculectomy' to a 'conventional' trabeculectomy, and found at least equivalence (equal IOP control, perhaps less failure), and encountered fewer complications, which they attribute to the use of a tunnel incision. The use of a shorter scleral flap and a tunnel incision, with valve-like properties, has previously been reported by others1 as a means of reducing the risk of late hypotony when antimetabolites are used. When one observes videos at meetings that illustrate the many modifications of glaucoma filtering surgery currently employed, it appears that there has been a trend away from the large, square scleral flap originally used by several surgeons and later popularized by Watson and Cairns, and towards shorter flaps and the use of tunnels, but rarely have there been reports such as this which attempt to document comparative results.
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