Microhook ab interno trabeculotomy, a novel minimally invasive glaucoma surgery

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Glaucoma necessitates interventions to lower intraocular pressure (IOP).
• Trabeculotomy (LOT) is a standard procedure to reduce aqueous outflow resistance.
• Traditional LOT can be invasive and technically demanding.

Purpose of the Study:

• To introduce the surgical technique of microhook ab interno LOT (µLOT).
• To highlight the advantages and tips for performing µLOT.
• To evaluate µLOT as a minimally invasive glaucoma surgery.

Main Methods:

• µLOT involves incising the trabecular meshwork and inner wall of Schlemm's canal via small corneal side ports.
• The technique utilizes small hooks for precise dissection.
• Surgical technique and tips are detailed for educational purposes.

Main Results:

• µLOT allows for a wider incision (two-thirds of the circumference) compared to traditional methods.
• Early case series suggest µLOT, alone or combined with cataract surgery, normalizes IOP postoperatively.
• The procedure is less invasive, simpler, and faster than ab externo LOT.

Conclusions:

• µLOT is a promising, minimally invasive surgical option for glaucoma management.
• The technique offers advantages in surgical extent, simplicity, and patient invasiveness.
• Further studies are warranted to confirm long-term efficacy and safety.