Glaucoma triple procedures leaving the internal corneal valve intact to control induced astigmatism--theoretic...

As glaucoma surgery increasingly tends to be performed in younger patients, stabilizing visual results by reducing the amount of surgically-induced astigmatism will become just as important as controlling intraocular pressure. I describe two glaucoma triple procedures involving small-incision cataract surgery in which, as contrasted with previous techniques, the internal cataract incision is separated from the trabeculectomy, theoretically reducing surgically-induced astigmatism. One method features a standard trabeculectomy with sutures in the scleral flap; the other, an ab externo trabeculectomy in which no sutures are used. The effectiveness of both these methods in actually reducing surgically-induced astigmatism, while controlling intraocular pressure (IOP), remains to be demonstrated, but the possibility that they might, seems well worth exploring.