Intraocular pressure control following microtrabeculectomy

The use of the Kelly Descemet's membrane punch enables the glaucoma surgeon to perform smaller trabeculectomies. The outcome of 'microtrabeculectomy' employing a 2 x 2 mm superficial scleral flap and a 0.75 mm internal osteum was evaluated on 65 eyes of 50 patients (mean age 70 years). The operation site was nasal in left eyes and temporal in right eyes. In the 56 eyes where 5-fluorouracil was not used, the mean intraocular pressure (IOP) on diagnosis was 33.4 mmHg, the mean pre-operative IOP being 25.1 mmHg. After a mean follow-up of 13.4 months (minimum 3 months) following surgery, the mean IOP was 13.4 mmHg with 88% of eyes controlled at < 21 mmHg on no medications. Nasally sited microtrabeculectomies resulted in lower IOPs than temporally sited procedures (11.8 vs 14.9 mmHg, p = 0.003) at last follow-up visit.