Abstract
A fundamental shift in philosophical direction is occurring in glaucoma surgery. This shift is toward restoring or exploiting of existing outflow pathways in hopes of avoiding the long-term complications of current incisional glaucoma therapy. The Trabectome and the iStent are two FDA-approved surgical therapies that increase trabecular outflow to lower IOP without the creation of a filtering bleb. The Trabectome surgery requires a Trabectome surgical unit, disposable single-use handpiece, and direct surgical gonioscope. The iStent requires an iStent pre-loaded on an applicator and a direct surgical gonioscope. Early results of both surgeries are comparable in terms of degree of technical difficulty, and both create postoperative IOPs in the mid to upper teens with decreased medical burden. These techniques are intended to integrate into cataract surgery to further minimize additional risks of these surgeries in mild to moderate disease state glaucoma patients.
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Hill, R., Minckler, D. (2014). Newer FDA-Approved Incisional Therapies. In: Samples, J., Schacknow, P. (eds) Clinical Glaucoma Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4172-4_28
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DOI: https://doi.org/10.1007/978-1-4614-4172-4_28
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