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Ab interno trabeculectomy: patient selection and perspectives.

Kateki Vinod¹, Steven J Gedde¹

¹Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

Clinical Ophthalmology (Auckland, N.Z.)

|August 31, 2016

Summary

Ab interno trabeculectomy offers a minimally invasive approach to glaucoma surgery, potentially reducing medication burden with a low complication rate. Further research is needed to confirm its benefits compared to other glaucoma surgeries.

Keywords:

ab interno trabeculectomy glaucoma intraocular pressure minimally invasive glaucoma surgery surgical outcomes

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Area of Science:

Ophthalmology
Surgical Innovation
Glaucoma Management

Background:

Traditional glaucoma surgery involves significant tissue disruption.
Minimally invasive glaucoma surgeries (MIGS) aim to reduce complications and recovery time.
Ab interno trabeculectomy represents a novel MIGS technique.

Purpose of the Study:

To describe the technique and outcomes of ab interno trabeculectomy.
To evaluate its efficacy in reducing intraocular pressure and medication burden.
To assess its safety profile and complication rates.

Main Methods:

Ablation of the trabecular meshwork and inner Schlemm's canal wall.
Performed via a clear corneal incision, standalone or combined with cataract surgery.
Data from small retrospective and prospective case series were analyzed.

Main Results:

Intraocular pressure reduction typically stabilizes in the mid-to-high teens.
Some studies show a reduction in medication burden.
Low complication rates reported, primarily transient hyphema and early IOP elevation.

Conclusions:

Ab interno trabeculectomy is a promising MIGS with a favorable safety profile.
Further randomized controlled trials are necessary.
Comparison with phacoemulsification alone and other MIGS is needed to define its role.