Internal Sclerectomy with an Automated Trephine for Advanced Glaucoma

Reay H. Brown, Mary G. Lynch, David B. Denham, Jean Marie Parel, Paul Palmberg, Donna D. Brown

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19 Scopus citations

Abstract

An automated trephine (trabecuphine) was used to perform an internal sclerectomy in seven glaucoma patients who were aphakic or had undergone previous filtering surgery that had failed or both. A patent fistula was achieved intraoperatively in all seven eyes. Postoperatively, six patients received subconjunctival injection of 5-fluorouracil (5-FU) once daily for an average of 8 days. Five of seven patients have retained a functional bleb and a controlled intraocular pressure (IOP) after sugery (follow-up, 4-24 months). The only intraoperative complication was hemorrhage from the sclerectomy site in a patient with anirida that resulted in a 20% hyphema. The hyphema cleared quickly, and the bleb has remained functional with a pressure of 12 mmHg for 9 months. The trabecuphine makes it possible to perform a glaucoma filtering operation safely from within the anterior chamber. This technique minimizes conjunctival trauma in the filtration area. The absence of a conjuctiva incision overlying the fistula simplifies the adjunctive use of antimetabolites such as 5-FU.

Original languageEnglish (US)
Pages (from-to)728-734
Number of pages7
JournalOphthalmology
Volume95
Issue number6
DOIs
StatePublished - Jan 1 1988

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Keywords

  • 5-fluorouracil
  • filtering surgery
  • filtering surgery failure
  • glaucoma in aphakia
  • glaucoma surgery
  • goniopuncture
  • trephine

ASJC Scopus subject areas

  • Ophthalmology

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