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Aqueous humor flow essential to non-penetrating glaucoma surgery
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SAN FRANCISCO — Adequate aqueous humor flow from the trabecular meshwork and Descemet’s membrane are “crucial” to successful non-penetrating glaucoma surgery, Kurt Von Wolff, MD, said.
He said changes in egress of aqueous humor from surgically exposed trabecular meshwork and Descemet’s window were apparent in about 900 cases he studied of viscocanulostomy performed to treat primary open-angle glaucoma. Surgeons can significantly increase aqueous flow after enlarging Descemet’s window by detaching Schwabe’s line with a Weck cell, he said. Surgeons can also increase aqueous flow by stripping the juxtacanicular tissue, Dr. Von Wolff said.
“Very seldom, even after stripping, the flow is not adequate,” he said. “At this time, we do radial perforation of the trabecular meshwork.”
He said the adequate exit of aqueous humor from the surgically exposed trabecular meshwork is crucial to successful non-penetrating glaucoma surgery. Surgical techniques should be applied to ensure sufficient flow, the study found.
He presented his results here at the American Society of Cataract and Refractive Surgery meeting.