Ab-interno sclerostomy using a goniodiathermy instrument.
We describe the use of a new instrument designed to create a simultaneous goniopuncture with diathermy using an ab-interno technique. The goniodiathermy ab-interno procedure was first performed on three eyes of three cynomolgus monkeys. Intraocular pressure (IOP) assessment and histologic examination were performed over a 10-day period. A functioning filtration bleb with a patent sclerostomy was achieved in all of the experimental eyes. A pilot study involving four eyes of four glaucoma patients also was performed. Of these four, successful long-term functioning filtration areas with adequate lowering of IOP were achieved in only two. The remaining two required further surgical intervention. Although combining goniopuncture and diathermy into a one-step ab-interno procedure proved successful in the primates studied, the preliminary use of this new instrument as a method of creating a filter in humans raises questions regarding its clinical usefulness.
Brown
S V
SV
Department of Ophthalmology, Northwestern University, Chicago, Ill.
Higginbotham
E J
EJ
Griffin
E O
EO
Zou
X
X
Edward
D
D
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000869:Anterior Eye Segment / Q000473:pathology; D003972:Diathermy / Q000295:instrumentation*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006068:Gonioscopy / Q000295:instrumentation*; D006801:Humans; D007429:Intraocular Pressure; D008252:Macaca fascicularis; D008297:Male; D015814:Ocular Hypotension / Q000601:surgery; D012599:Sclerostomy / Q000379:methods*