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S. Mosaed, D.S. Minckler, G. Baerveldt, M.A. Ramirez, B.A. Francis; Surgical Results With the Trabectome for Open Angle Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3546.
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To summarize the 24 month to 36 month results in patients who underwent surgery with the Trabectome device. This will provide follow up to the initial study that has recently been published. The Trabectome is a novel surgical device FDA approved for the treatment of adult and juvenile open angle glaucoma.
49 adult glaucoma patients on maximal tolerated medical therapy with IOP> 21mmHg underwent ab interno trabeculotomy with the Trabectome device. The procedure involves electro–cautery ablation of approximately 30 degrees of the trabecular meshwork through a small paracentesis, under gonioscopic visualization with retrobulbar anesthesia. The device allows for simultaneous infusion and aspiration during electro–ablation. The trabecular meshwork and inner wall of Schlemm’s canal are removed while the outer wall of Schlemm’s is protected from thermal injury with an insulating footplate.
90% of patients maintained IOP of < 21 mmHg after 24 months with or without medications. This represents a 44% + 13% reduction in IOP from a pre–operative mean of 28mmHg to an average of 15.3mmHg + 2.3.mmHg at 24 months. The main complication experienced was transient intra–operative hyphema from blood reflux into Schlemm’s canal. There were no serious complications such as hypotony, endophthalmitis, choroidal effusions, wound leaks, or serious vision loss typically associated with traditional glaucoma surgery.
The trabectome represents a promising new surgical modality for effective, yet minimally invasive treatment of open –angle glaucoma. References:
1. Minckler DS, Baerveldt G, Alfaro MR, Francis BA, Clinical Results with the Trabectome for Treatment of Open–Angle Glaucoma. Ophthalmology 2005:112;962–967.
2. Francis BA, See RF, Rao NA, Minckler DS, Baerveldt G. Ab interno trabeculectomy: development of a novel device (Trabectome) and surgery for open–angle glaucoma. Journal of Glaucoma 2005; in press.
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