Novel Trabeculotomy-related Glaucoma Surgeries

Trabeculotomy reduces intraocular pressure by relieving the resistance to aqueous flow via cleavage of the trabecular meshwork and inner walls of Schlemm’s canal at the point of outflow resistance of the aqueous humor. Because of the absence of a bleb, late-onset sight-threatening complications, such as hypotony maculopathy and endophthalmitis, that are associated occasionally with trabeculectomy develop less often after trabeculotomy. Several recently reported procedures, including the Trabectome, Kahook Dual Blade, microhook ab interno trabeculotomy, and 360° suture trabeculotomy, use the ab interno approach, instead of the ab externo approach that use in conventional trabeculotomy. These novel, minimally invasive, trabeculotomy-related glaucoma surgeries can be good options for certain glaucoma scenarios including early-stage open-angle glaucoma, developmental glaucoma, and glaucoma in elderly patients.