PubMed · 11339575
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M Papadopoulos, P T Khaw. 2001. Improving glaucoma filtering surgery.. https://doi.org/10.1038/eye.2001.45
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Trabeculectomy is still considered to be the gold standard in the surgical treatment of the open-angle glaucomas. The additional application of local antimetabolites has reduced the rate of early filtering bled fibrosis, but increased the rate of essential late-postoperative complications. Growth factor inhibition and photodynamic therapy may be an alternative local treatment to enhance the results in filtering surgery. Non-penetrating glaucoma surgery and ab-interno trabecular surgery have several conceptual advantages, e.g. the lack of overfiltration or the untouched conjunctiva in the ab-interno approach. Clinical studies of these and other new procedures including antiglaucomatous retinectomy and subchoroidal shunt systems are currently performed in order to evaluate their potential and limits in the clinical management of glaucoma.
Trabeculectomy is currently the standard filtration procedure for surgical treatment of glaucoma. This technique has advantages over full thickness procedures but can cause early postoperative complications such as hyphema, shallow or flat anterior chamber, hypotony with the risk of choroidal detachment, and maculopathy. Nonpenetrating procedures are alternatives to trabeculectomy with the advantage of minimizing the risk of postoperative complications related to hypotony. The two major variations of nonpenetrating glaucoma surgery are nonpenetrating deep sclerectomy and viscocanalostomy. Techniques and results are discussed in this paper.