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...

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Bibliographic Details
Published inJournal of cataract and refractive surgery Vol. 28; no. 12; pp. 2080 - 2083
Main Authors Sourdille, Philippe, Santiago, Pierre-Yves, Bresson-Dumont, H.élène
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.12.2002
Elsevier Science
Subjects
Adult
Biological and medical sciences
Glaucoma, Open-Angle - surgery
Humans
Intraocular Pressure
Intraoperative Complications - prevention & control
Medical sciences
Ophthalmology - education
Sclerostomy - methods
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the eye and orbit
Trabeculectomy - methods
Human
Trabeculectomy
Eye disease
Treatment
Open angle glaucoma
Sclerectomy
Surgery
Sclerotrabeculectomy
Technique
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Summary: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.
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ISSN:0886-3350
1873-4502
DOI:10.1016/S0886-3350(02)01363-9