Perspectives in trabecular surgery

The aim of trabecular surgery is to selectively combat the diseased structu re central to the pathogenesis of chronic open-angle glaucoma, thereby redu cing potential hazards during and after conventional filtering procedures. This overview considers new techniques in ab interno trabecular surgery. Sp ecial emphasis is placed on the description of each novel technique, its in strumentation, presumed mechanism of action and clinical results. Trabecula r aspiration is evaluated as a method of clearing intertrabecular spaces of extracellular debris in pseudoexfoliation glaucoma with or without simulta neous cataract surgery or goniocurettage, while laser trabecular ablation i s discussed for the treatment of absolute glaucomas. Where corneal haze has formed visualisation of the anterior chamber angle structures and trabecul ar surgery is performed with the aid of a microendoscope. Although the resu lts are very promising it should be understood that some of these procedure s are still in the experimental phase and are undergoing careful clinical e valuation, leaving plenty of roam for refinements and further developments.