Transition to nonpenetrating trabecular surgery: sclerotrabeculectomy.
A transition from trabeculectomy to nonpenetrating trabecular surgery (NPTS) is proposed under the name of sclerotrabeculectomy. The technique, which is aimed at facilitating the transition to NPTS, is a modification of both penetrating and nonpenetrating techniques. Sclerotrabeculectomy uses a more superficial sclerokeratectomy than NPTS to avoid the risk of perforation. A minitrabeculectomy with cross-linked hyaluronate implant insertion in the sclerokeratectomy site is performed, with several sutures placed in the superficial flap. The sclerokeratectomy site is filled with cohesive viscoelastic substance to avoid a flat or shallow anterior chamber. Using this technique, it is possible to move to NPTS by finding the pre-Descemet's plane in front of the scleral spur and removing the external trabeculum. In case of accidental microperforation of Descemet's plane, the operation is finished as a standard sclerotrabeculectomy with no risk to the patient's eye. A safe transition can thus be achieved. Initial clinical results demonstrate excellent lowering of intraocular pressure without significant complications.
Sourdille
Philippe
P
Clinique Sourdille, 8 Rue Camille Flammarion, Nantes, France.
Santiago
Pierre Yves
PY
Bresson-Dumont
Hélène
H
D000328:Adult; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications / Q000517:prevention & control; D009885:Ophthalmology / Q000193:education; D012599:Sclerostomy / Q000379:methods*; D014130:Trabeculectomy / Q000379:methods*