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Reopening of failed trabeculectomies with ab interno Nd:YAG laser
A Kandarakis1, P Mitropoulos, M Angelou
1Glaucoma Clinic, 2nd Department of Ophthalmiatrion Eye Hospital, Athens, Greece.
Purpose:
To test the efficacy of ab interno Nd:YAG laser in reopening closed trabeculectomies and to specify the factors influencing the success or failure of the revision.
Methods:
27 patients underwent ab interno revision of their failed trabeculectomies with a Q switched, single-shot Cooper Vision 2500 Nd:YAG laser. The cause of obstruction was iris in 12 patients, transparent membrane in sclerectomy in 8 and fibrosis of the scleral flap in the remaining 7. The pre-laser IOP ranged from 28 to 40 mmHg, the patients' ages from 42 to 75 years and the time between the trabeculectomy failure and the revision from 3 to 17 months. The total energy given to each eye per session, using a gonioscope, ranged from 30 to 1185 mj.
Results:
Post-laser follow-up ranged from 6 to 32 months. IOP was controlled in 20 of 27 cases.
Conclusions:
We believe that factors influencing the success of the revision are the patient's age, the kind and location of the obstacle and the time elapsed between the failure of the trabeculectomy and the Nd:YAG revision.