Antiglaucomatous trabecular surgery.

Abstract

In contrast to conventional filtering procedures, microtrabecular surgery is intended to selectively combat the diseased structure in the pathogenesis of chronic open-angle glaucoma, thereby reducing potential risks during and after transscleral drainage operations. This overview considers new techniques in trabecular surgery, with special emphasis on the description of each novel technique, its instrumentation, its presumed mechanism of action, and its clinical results. Trabecular aspiration is evaluated as a method of clearing extracellular debris from intertrabecular spaces in pseudoexfoliation glaucoma or goniocurretage, and laser trabecular ablation for the treatment of absolute glaucomas is discussed. Although preliminary results are promising, most of these procedures are still experimental and under careful clinical evaluation, leaving plenty of room for refinements and further developments.