ABINTERNO SCLEROSTOMY USING A GONIODIATHERMY INSTRUMENT

We describe the use of a new instrument designed to create a simultane ous goniopuncture with diathermy using an ab-interno technique. The go niodiathermy ab-interno procedure was first performed on three eyes of three cynomolgus monkeys. Intraocular pressure (IOP) assessment and h istologic examination were performed over a 10-day period. A functioni ng filtration bleb with a patent sclerostomy was achieved in all of th e experimental eyes. A pilot study involving four eyes of four glaucom a patients also was performed. Of these four, successful long-term fun ctioning filtration areas with adequate lowering of IOP were achieved in only two. The remaining two required further surgical intervention. Although combining goniopuncture and diathermy into a one-step ab-int erno procedure proved successful in the primates studied, the prelimin ary use of this new instrument as a method of creating a filter in hum ans raises questions regarding its clinical usefulness.