Filtering glaucoma surgery using an excimer laser

To evaluate the results of excimer laser trabecular ablation in the treatment of open-angle glaucoma.

Clínica de Ojos Maldonado Bas Privada, Córdoba, Argentina.

This study comprised 32 eyes that had surgery for open-angle glaucoma between May 1997 and May 2000. The surgical procedure included topical anesthesia, a conjunctival incision, a lamellar scleral flap, and ablation of Schlemm's canal and the trabeculum with a scanning or diaphragm excimer laser system until a microperforation was produced in the underlying corneotrabecular tissue. The microperforation had no effect on the treatment and was used only as a sign that the ablation was deep enough and should be stopped. Schlemm's canal was unroofed, and its inner wall and the trabeculum were partially ablated. The scleral flap and conjunctiva were sutured. No antimetabolites were used.

The mean intraocular pressure was 28.06 mm Hg +/- 9.82 (SD) preoperatively and 13.09 +/- 2.67 mm Hg postoperatively. Complications included hyphema (n = 3), choroidal detachment (n = 5), posterior synechias (n = 1), and posterior synechias and cataract (n = 1).

Excimer laser ablation appears to be an effective option for the treatment of glaucoma that may be easier to perform than other procedures for many surgeons.