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Angle Surgery: Trabeculotomy

  • Beth Edmunds
  • Allen D. Beck
  • Esther Hoffmann
  • Franz Grehn
Chapter

Abstract

In this section, we address the role and execution of ab externo trabeculotomy in pediatric glaucoma. We provide an in-depth comparison of different techniques with detailed descriptions of traditional trabeculotomy with metal trabeculotome, ab externo circumferential trabeculotomy with either an illuminated microcatheter or blunted suture filament, and trabeculotomy combined with filtration surgery such as combined trabeculectomy-trabeculotomy and filtering trabeculotomy. For each there are sections on preoperative preparation, execution of the relevant surgery (with tips for problem-solving and avoiding complications), and postoperative management of the child. In addition, there is a comprehensive review of the literature to date, describing the evolution of trabeculotomy in the management of the pediatric glaucomas, and the evidence base for variations in technique, surgical preferences, and outcomes.

Keywords

Trabeculotomy Pediatric glaucoma Circumferential (360) trabeculotomy Combined trabeculectomy-trabeculotomy Filtering trabeculotomy Complications Outcomes 

Supplementary material

Video 5.1

Conventional trabeculotomy with metal trabeculotome (Courtesy of Professor Nader Bayoumi, Alexandria University, Egypt) (MP4 10860 kb)

Video 5.2

Circumferential trabeculotomy, ab externo, with illuminated microcatheter (Courtesy of Beth Edmunds, MBChB, FRCOphth, MD) (MP4 80191 kb)

Video 5.3

Circumferential trabeculotomy, ab externo, with blunted suture (Courtesy of Allen D. Beck, MD) (MPG 95372 kb)

Video 5.4

Filtering trabeculotomy (Courtesy of Franz Grehn, MD, PhD) (MP4 153032 kb)

Video 5.5

Combined trabeculectomy-trabeculotomy (CTT) (Courtesy of Professor Nader Bayoumi, Alexandria University, Egypt) (MP4 178733 kb)

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Beth Edmunds
    • 1
  • Allen D. Beck
    • 2
  • Esther Hoffmann
    • 3
  • Franz Grehn
    • 4
  1. 1.Casey Eye InstituteOregon Health and Science UniversityPortlandUSA
  2. 2.Department of OphthalmologyEmory UniversityAtlantaUSA
  3. 3.Department of OphthalmologyChildhood Glaucoma Center, University Medical Center MainzMainzGermany
  4. 4.Department of OphthalmologyUniversity Hospitals WürzburgWürzburgGermany

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