[Clinical results of the goniothrephining with scleral flap (author's transl)]

During 1971-1976 407 goniotrephinings e.g. "Elliot with scleral flap", were performed at the Univ. Eye Hospital Münster. In a follow-up study of 306 operated cases we found 81% primary glaucoma (62.7% simple glaucoma, 18.3% chronic congestive glaucoma) and 19% secondary glaucoma. In 77% of the operated cases the anterior chamber was restored within the first postoperative day. Gonioscopically in 85% the trephining hole was placed within the trabecular meshwork. Nevertheless, this position of the hole had no decisive influence on the later filtration. Postoperatively 2/3 of cases developed a characteristic flat filtering bleb. In 90.4% of the eyes the postoperative IOP was within normal limits. Postoperative follow-up of the visual acuity remained within the limits of age deterioration. Concerning the secondary glaucoma, the pigmentary glaucoma, the traumatic glaucoma and the glaucoma after uveitis, had good results. The results in cases of buphthalmos and hemorrhagic glaucoma were worse. The advantages of goniotrephining are the rapid restoring of the anterior chamber, the protection of the trephining hole by the scleral flap as well as the well "protected" flat and infections-resisting bleb.