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Abstract
Purpose
To report a case of ab interno trabeculotomy with Trabectome® (NeoMedix Corp., CA, USA) conducted on a refractory primary open angle glaucoma (POAG) patient.
Case summary
Trabectome® has microelectrocautery with simultaneous infusion and aspiration of debris and ablates a segment of trabecular meshwork and the inner wall of Schlemm’s canal. The patient, a 54-year-old man had uncontrolled intraocular pressure (IOP) with topical anti-glaucoma medications after trabeculectomy and Ahmed valve implantation for POAG. For the patient, ab interno trabeculotomy with Trabectome® was performed. There were no other postoperative complications except for microhyphema immediately after surgery. The IOP was controlled between 14 to 24 mm Hg up to 3 months postoperatively with topical anti-glaucoma medications (Cosopt®, Alphagan-P®, Lumigan®).
References
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Figure 1.
Trabectome surgical steps. (A) Create a 1.6-mm clear corneal incision. (B) Inject a small amount of viscoelastic at the incision site. (C) Place Goniolens on the cornea and verify the angle view. (D) Ablate the trabecular meshwork for approximately in counter-clockwise direction. (E) Rotate the tip. (F) Re-insert the tip in the clockwise direction and remove a similar arc. (G) Irrigate and aspirate viscoelastics from the anterior segment. (H) Place one suture across the incision. Arrow: direction of Trabectome® tip.
Figure 2.
Gonioscopic findings of the patient at 3 months after surgery. Posterior wall of Schlemm’s canal is visible in the area where the trabecular meshwork is removed by Trabectome®. Long arrow, ablation range of the trabecular meshwork; small arrow, white shimmering of the posterior wall of Schlemm’s canal.
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