Selective trabeculectomy. A report of a new surgical method for open angle glaucoma

A new instrument, the trabeculectome, and an new surgical method for treating open angle glaucoma is described. The double-edged instrument makes 2 cuts through the trabecular meshwork while being pulled through Schlemm's canal, thus cutting free a strip of the trabecular meshwork and the inner wall of Schlemm's canal. The results of the 21 first operations are presented. The observation time is 9-19 months. The characteristic post-operative pressure pattern is an immediate fall to 10-20 mmHg followed by a period of higher pressures which then converge to the range of 8-16 mmHg with most eyes in the 10-14 mmHg range. Four patients need timolol treatment to obtain this, the remaining 17 have no medication. The therapeutic results and additional observations are discussed with special interest to possible physiological mechanisms.