The long-term results of fistulising trabeculotomy in chronic open-angle glaucoma

Fistulising trabeculotomy has been used for nearly 20 years to combine the minimally invasive surgery of trabeculotomy with production of a subconjunctival fistula.

The canal of Schlemm was unroofed 2mm on one side of a 3mm half-thickness scleral flap. A trabeculotomy probe was passed about 30 degrees along the canal on the opposite side and rotated into the anterior chamber.

Of 99 eyes of 74 patients, 35 eyes of 25 patients were available for follow-up at 10 or more years. The mean IOP was 14 +/- 4 mmHg (range 7 to 23 mmHg) from a preoperative IOP of 29 +/- 8 mmHg (17 to 60 mmHg). Results in 44 similar patients undergoing trabeculectomy and 44 undergoing fistulising trabeculotomy were very similar at five-year follow-up.

Fistulising trabeculotomy was effective for lowering intraocular pressure with a low complication rate and a large area of subconjunctival fistulisation.