The use of the Kelly Descemet's membrane punch enables the glaucoma su
rgeon to perform smaller trabeculectomies. The outcome of 'microtrabec
ulectomy' employing a 2 x 2 mm superficial scleral flap and a 0.75 mm
internal osteum was evaluated on 65 eyes of 50 patients (mean age 70 y
ears). The operation site was nasal in left eyes and temporal in right
eyes. In the 56 eyes where 5-fluorouracil was not used, the mean (IOP
) on diagnosis was 33.4 pre-operative IOP being 25.1 mmHg. After a mea
n follow-up of 13.4 months (minimum 3 months) following surgery, the m
ean IOP was 13.4 mmHg with 88% of eyes controlled at <21 mmHg on no me
dications. Nasally sited microtrabeculectomies resulted in lower IOPs
than temporally sited procedures (11.8 vs 14.9 mmHg, p = 0.003) at las
t follow-up visit.