Abstract
We have performed ab-externo photoablative filtration surgery on 19 patients affected by uncontrolled primary open-angle glaucoma. All cases had wide open angles, were previously treated with argon laser trabeculoplasty and were considered good candidates for trabeculectomy. After topical and peribulbar anesthesia, a limbus-based conjunctival flap was dissected. Photoablation of a rectangular area at the limbus was performed with an argon fluoride excimer laser (193 nm), at 180mJxsq cm fluence. The beam was shaped in the appropriate fashion using a custom-made metal mask. Photoablation was continued until aqueous appeared percolating through the juxtacanalicular tissue at the bottom of the crater; a water-tight closure of conjunctiva was then performed. Postoperatively, the anterior chamber reaction was minimal; in no case a flat chamber or choroidal detachment was observed. In 18 of the 19 cases the IOP was significantly lowered, and a filtering bleb developed. Mean preoperative IOP was 26.4 (±7) mmHg. At a median follow-up of 9 months (range 4–15) the IOP is<18 mmHg on no medications in 16 (84%) of the eyes, with a mean value of 13.3 (±6) mmHg. Our short-term results support excimer laser photoablative filtration as a relatively safe and effective procedure for primary open-angle glaucoma.
Similar content being viewed by others
References
L'Esperance FA, Warner JW, Telfair WB, Yoder PR, Martin CA. Excimer laser instrumentation and technique for human corneal surgery. Arch Ophthalmol 1989; 107: 131–9.
Kerr-Muir MG, Trokel SL, Marshall J, Rothery S. Ultrastructural comparison of conventional surgical and argon fluoride excimer laser keratectomy. Am J Ophthalmol 1987; 103: 448–53.
Sciler T, Wollensak J, The resistance of the trabecular meshwork to aqueous humor outflow. Graefe's Arch Clin Exp Ophthalmol 1985; 223: 88–91.
Sciler T, Kriegerowski M, Patmore A, Marshall J. Partial external trabeculectomy with excimer laser: an experimental investigation of a new treatment for glaucoma. Laser Light Ophthalmol 1990; 3, 2: 97–109.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Traverse, C.E., Muriaido, U., Di Lorenzo, G. et al. Photoablative filtration surgery with the excimer laser for primary open-angle glaucoma: a pilot study. Int Ophthalmol 16, 363–365 (1992). https://doi.org/10.1007/BF00917992
Issue Date:
DOI: https://doi.org/10.1007/BF00917992