INTRACANALICULAR TRABECULOSTOMY - A NEW A PPROACH IN GLAUCOMA SURGERY

Background A new ''ab externo'' technique for glaucoma trabecular surg ery creating multiple perforations of the trabeculum to improve outflo w facility was tested. Material and Method In order to perform a drain ing canal to the anterior chamber, a quartz fiber (empty set: 300 mu m ) with a side-firing tip, coupled to an Er:YAG laser (2.94 mu m), was inserted into Schlemm's canal of an enucleated human eye. Results Eigh t pulses of 8 mJ each were sufficient to perforate the trabecular mesh work. Histologic analysis showed a rippled canal with 50 mu m average diameter and a surrounding necrosis zone of 15-35 mu m. Conclusions Th e Er:YAG laser trabeculostomy, in conjunction with special fibers, sho ws promise as a new ''ab externo'' technique for minimally invasive th erapy of open angle glaucoma.