[Surgical options before and after trabectome surgery : Impact of previous surgeries, possibilities of revision surgery and complication management].
BACKGROUND
Trabectome surgery is a new method to lower intraocular pressure through ablation of the trabecular meshwork. Technically, it is an ab interno trabeculotomy. The goal of this review is to investigate the options after failed trabectome surgery and evaluate the possibilities of trabectome surgery after failed previous glaucoma surgery.


OBJECTIVE
A literature review was performed to answer the following questions: (1) Is trabectome surgery an option after failed glaucoma surgery? (2) Is trabeculectomy an option after failed trabectome surgery? (3) Which postoperative constellations require early revision surgery after trabectome surgery?


RESULTS
Trabectome surgery is an option after failed trabeculectomy or failed tube surgery. Performing a trabeculectomy after failed trabectome surgery did not show disadvantages. Hypotony or hyphema is rare and self-limiting and, therefore, does not require further surgery.


CONCLUSIONS
Due to a lack of randomized studies, recommendations should be taken with caution.
Augenabteilung, St. Martinus-Krankenhaus, Gladbacher Str. 26, 40219, Düsseldorf, Deutschland. r.widder@martinus-duesseldorf.de.
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RA
Widder
Zentrum für Augenheilkunde, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
T S
TS
Dietlein
D015984:Causality; D015897:Comorbidity; D055318:Evidence-Based Nursing; D006801:Humans; D009798:Ocular Hypertension / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors; D014130:Trabeculectomy / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome
Glaucoma; Intraocular pressure; Laser trabeculopasty; Miotics; Surgical revision