CLINICAL CASE A 71-year-old woman presented with a leaking bleb after a combined phacotrabeculectomy performed 13 years ago. To construct a new filtering bleb, the necrotic area was fully excised. The amniotic membrane was inserted over the scleral flap underneath healthy conjunctiva edges. A conjunctiva-Tenon autograft from the contralateral eye was sutured and was sealed with fibrin adhesive....

An iridencleisis is added to the original trabeculectomy technique of Cairns as modified by Watson for the surgical treatment of glaucoma. The steps are described with special reference to the fashioning of the iridencleisis as an iris tongue lying curled upon itself with the pigmented layer lining the inner aspect of the iris resting between the scleral flaps. Two series of patients from Afric...

AIM To determine the long-term efficacy of small flap trabeculectomy (microtrabeculectomy) in terms of intraocular pressure (IOP) control in relatively low risk eyes. METHOD A review of a case series of small flap trabeculectomy procedures performed on 36 eyes from 36 patients with a minimum follow up of 24 months (mean 50.8). RESULTS The mean (SD) intraocular pressures at presentation and ...

BACKGROUND Neovascular glaucoma (NVG) is a devastating ocular disease with poor prognosis. The ideal surgical procedure has yet to be determined. In this study, the clinical course and visual outcome of NVG and their fellow eyes were investigated and the most appropriate management was also evaluated. METHODS The study was conducted retrospectively consisting of NVG in-patients of Taipei Vete...

We describe an innovative technique for performing standardized low cost glaucoma filtration surgery using a polytetrafluoroethylene (PTFE) intravenous cannula. The trocar of a 24 gauge (24G) PTFE intravenous cannula was used to create a trabeculectomy ostium and its tube was inserted under a partial thickness scleral flap in 2 patients with advanced glaucomatous optic neuropathy, in whom intra...

O cular hypotony is associated with significant visual dysfunction depending on its severity and duration. One etiology of hypotony is cyclodialysis cleft (CDC), a disinsertion of the longitudinal ciliary muscle fibers from the scleral spur. Originally described as a planned surgical treatment for intractable glaucoma, CDC may be observed following trauma or as an inadvertent surgical event fro...

BACKGROUND The purpose of this study was to compare the outcomes of trabeculectomy using single sutures or releasable sutures. METHODS This retrospective study analyzed the medical records of 61 patients who had undergone trabeculectomy using single sutures (n = 33, 54.1%) or releasable sutures (n = 28, 45.9%). The scleral flap was secured with a mean 3.9 (range 3-5) single sutures in 33 pati...

In 1989, Koslov et al. described ‘deep sclerectomy’ (DS): an ‘en-bloc’ resection of the external wall of Schlemm’s canal, along with corneal stroma adjacent to the anterior trabeculum and, more anteriorly, exposure of Descemet’s membrane over 4–5 mm. These structures were removed with a slice of sclera beneath a superficial scleral flap: hence the term deep sclerectomy. In 1998, Vaudaux et al. ...

PURPOSE To evaluate the effects of mitomycin C and a releasable suture technique on outcomes of primary trabeculectomy in primary glaucoma patients. METHODS A prospective analysis of patients who underwent primary trabeculectomy with a mitomycin C concentration of 0.2 mg/mL for 2 minutes. For closing the scleral flap, releasable sutures were used in 18 patients (17 eyes), Group 1, or permanen...

Current Opinion in Ophthalmology 2008, 19:149–154 Purpose of review Despite late modifications and enhancements, traditional penetrating glaucoma surgery is not without complications and is reserved for patients in whom pharmacologic treatment and/or laser trabeculoplasty do not suffice to control the intraocular pressure This article critically reviews recent advances in penetrating glaucoma s...