[Intraocular pressure reduction by endoscopically controlled erbium:YAG goniotomy].
BACKGROUND
Microperforations of the trabecular meshwork can be made using an endoscope guided Er:YAG laser. As shown in enucleated human melanoma eyes, these microperforations are not accompanied by thermal damage of the surrounding tissue. We now report our first clinical results using a commercially available endoscope/laser system for performing this particular kind of goniotomy.


METHODS
A combined cataract extraction and Er:YAG goniotomy was performed in 24 eyes of 20 patients. Seventeen eyes were reexamined after a minimum follow-up of 4 months (mean 6.5 months, max. 12 months). The results were compared to a control group having only the cataract operation (14 eyes).


RESULTS
After combined cataract operation and Er:YAG goniotomy, mean intraocular pressure dropped from 21.8 to 15.5 mmHg. Intraocular pressure regulation was successful in 88% of these cases. In contrast to this, the intraocular pressure reduction in eyes having only the cataract operation was much less pronounced (mean intraocular pressure preoperative 20.0, postoperative 17.4, success rate 35%).


CONCLUSIONS
The first results with our particular endoscope/laser system are encouraging. Other groups using comparable devices have reported similar success rates. We hope that the endoscopic Er:YAG goniotomy may become a minimally invasive type of glaucoma surgery in the near future.
Funk
J
J
Universitäts-Augenklinik Freiburg.
Feltgen
N
N
Asbeck
D
D
D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D004871:Erbium; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D018918:Phacoemulsification; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*
D004871:Erbium