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[Intracanalicular trabeculostomy--a new approach to glaucoma surgery]
J Kampmeier1, K Stock, R Hibst
1Universitäts-Augenklinik und Poliklinik, Universität Ulm. juergenk@hsc.usc.edu
Background:
A new "ab externo" technique for glaucoma trabecular surgery creating multiple perforations of the trabeculum to improve outflow facility was tested.
Material And Method:
In order to perform a draining canal to the anterior chamber, a quartz fiber (phi: 300 microns) with a side-firing tip, coupled to an Er:YAG laser (2.94 microns), was inserted into Schlemm's canal of an enucleated human eye.
Results:
Eight pulses of 8 mJ each were sufficient to perforate the trabecular meshwork. Histologic analysis showed a rippled canal with 50 microns average diameter and a surrounding necrosis zone of 15-35 microns.
Conclusions:
The Er:YAG laser trabeculostomy, in conjunction with special fibers, shows promise as a new "ab externo" technique for minimally invasive therapy of open angle glaucoma.