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Trabeculotomy ab interno with internal limiting membrane forceps for open-angle glaucoma

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Abstract

Purpose

To describe a new technique to perform trabeculotomy ab interno on eyes with open-angle glaucoma (OAG).

Methods

This was a retrospective study. We inserted a 25-gauge forceps that is usually used for internal limiting membrane peeling into the anterior chamber, and grasped and pulled the inner wall of Schlemm’s canal away from the canal. The inner wall of Schlemm’s canal was stripped for about 100° to 120° in 26 eyes of 23 patients. The intraocular pressure (IOP) and number of glaucoma medications were recorded before, and 1 day, 1 week, 2 weeks, and 1, 3, 6, 10, 12, 15, 17, 19, 24, 27, 30, and 33 months after the surgery. The intra- and postoperative complications were recorded.

Results

The mean ± standard deviation of the preoperative IOP was 20.0 ± 6.8 mmHg with a range from 10 to 38 mmHg (n = 26). The IOP was significantly reduced (P < 0.05; paired t-tests) at 1 week, 2 weeks, and 1, 3, 6, 10, 12, 15, 17, 24, 19, 27, 30, and 33 months after the surgery. The mean preoperative number of glaucoma medications was significantly reduced (P < 0.001; paired t-tests) at 1 week, 2 weeks, and 1, 3, 6, 10, 12, 15, 17, 19, 24, 27, 30, and 33 months after the surgery. No vision-threatening complications were found in any of the cases, but there were blood clots in the anterior chamber postoperatively in 92.3 % of the cases.

Conclusions

Trabeculotomy ab interno for OAG is effective but with some minor complications. A larger number of patients with longer follow-up periods are needed to determine the long-term effectiveness of this procedure.

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Acknowledgments

We thank Professor Duco I. Hamasaki, PhD for editing this manuscript.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests

None declared

Contributorship statement

Houmei Nakasato and Riyo Uemoto: All works.

Masaru Isozaki: histological section

Tatsukata Kawagoe and Akira Meguro: analysis of data.

Nobuhisa Mizuki: Design.

Author information

Correspondence to Riyo Uemoto.

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Nakasato, H., Uemoto, R., Isozaki, M. et al. Trabeculotomy ab interno with internal limiting membrane forceps for open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 252, 977–982 (2014) doi:10.1007/s00417-014-2616-4

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Keywords

  • Trabeculotomy ab interno
  • 25G internal limiting membrane forceps
  • Modified Swan–Jacobs lens