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Trabeculostomy works best in combination surgeries
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NUREMBERG, Germany — Excimer laser trabeculostomy gives the best results when combined with other surgeries such as cataract, one glaucoma specialist told an audience here.
“Excimer laser trabeculostomy is my favorite type of laser,” Jens Funk, MD, PhD, told attendees at the German Ophthalmic Surgeons conference. “Slowly but surely, I am starting to believe in this method.”
According to Dr. Funk, a 2-year follow-up with patients who had undergone the surgery showed a mean patient pressure of 21 mm Hg after surgery. A combined therapy had an 80% success rate, which was much higher when compared with treatments for high IOP alone, he said.
“Indications for combined surgery are quite generous,” Dr. Funk said.
Dr. Funk said when comparing excimer laser trabeculostomy to argon laser or selective laser trabeculoplasty, advantages to the excimer laser treatment include that it is minimally invasive, it leaves no conjunctival scar, and it takes less than 2 minutes to perform. Other advantages include a combined laser and endoscope and a laser filter of 3 to 4 mm in diameter, he said.
The laser can be inserted across the anterior chamber and is placed into the iride corneal angle where small holes are placed in the trabecular meshwork.
“You can open the trabecular meshwork without destroying the posterior wall of Schlemm’s canal,” he said. “Laser treatment should come before filtering surgery in my opinion.”