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Procedural Treatments: Trabeculectomy

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Pearls of Glaucoma Management

Abstract

In trabeculectomy, the initial conjunctival incision can be created either at the limbus or in the fornix. This results in two different surgical approaches: (a) a limbal-based conjunctival flap (LBCF) – incision is deep in the fornix with the base at the limbus and (b) a fornix-based conjunctival flap (FBCF) – incision is at the limbus with the base in the fornix. Cairns introduced the LBCF in his original description of trabeculectomy [1]. The FBCF was suggested later by Luntz in 1980 [2]. Luntz’s aim was to have a surgical approach that offered better visualization of the scleral flap during construction, and he felt that the FBCF resulted in more posteriorly located blebs. Bleb characteristics that are considered desirable include a low, diffuse profile, flow that is directed posteriorly over a large surface area, and some vascularity, so that the bleb does not break down easily.

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References

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Acknowledgements

The authors acknowledge the support of Guide Dogs for the Blind, the Wellcome Trust, Medical Research Council, Moorfields Trustees, the Haymans Trust, Ron and Liora Moskovitz Foundation, the Michael and Ilse Katz Foundation, the Helen Hamlyn Trust in memory of Paul Hamlyn and Fight for Sight (UK). This research has received a portion of its ­funding from the Department of Health’s National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health.

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Authors and Affiliations

  1. National Institute for Health Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, 11-43, Bath Street, London, EC1V 9EL, UK

    Peng Tee Khaw

Authors
  1. Thomas Ressiniotis
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  2. Peng Tee Khaw
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Correspondence to Peng Tee Khaw .

Editor information

Editors and Affiliations

  1. Jules Stein Eye Institute, Stein Plaza 100, Los Angeles, 90095, U.S.A.

    JoAnn A. Giaconi

  2. Jules Stein Eye Institute, Stein Plaza 100, Los Angeles, 90095, U.S.A.

    Simon K. Law

  3. Jules Stein Eye Institute, Stein Plaza 100, Los Angeles, 90095, U.S.A.

    Anne L. Coleman

  4. Jules Stein Eye Institute, Stein Plaza 100, Los Angeles, 90095, U.S.A.

    Joseph Caprioli

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Ressiniotis, T., Khaw, P.T. (2010). Procedural Treatments: Trabeculectomy. In: Giaconi, J., Law, S., Coleman, A., Caprioli, J. (eds) Pearls of Glaucoma Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68240-0_35

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  • DOI: https://doi.org/10.1007/978-3-540-68240-0_35

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  • Print ISBN: 978-3-540-68238-7

  • Online ISBN: 978-3-540-68240-0

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