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Ab interno trabeculotomy preferred for open-angle glaucoma, cataract
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NEW ORLEANS — Ab interno trabeculotomy is preferable to other procedures in eyes with concurrent cataract and open-angle glaucoma, a speaker told colleagues here.
Sameh Mosaed, MD, described the advantages of ab interno trabeculotomy with implantation of the Trabectome (NeoMedix). She also shared pearls on the procedure.
First, the surgeon needs adequate visualization of the surgical field. Second, the patient’s head should be turned away from the surgeon, and the microscope should be tilted accordingly. Last, patient selection is critical for success, Mosaed said.
“Patients in whom the pathology of their glaucoma is truly trabecular in nature do much better with this device and procedure than other patients,” Mosaed said. “These are pseudoexfoliated patients, pigmentary glaucoma. I find that steroid-induced patients do very well with it. And the combined phakic IOL patients tend to do well.”
Ab interno trabeculotomy can be performed alone in phakic or pseudophakic eyes or in combination with cataract extraction, can be used to treat adult or juvenile glaucoma, and does not preclude standard filtering surgery or affect the outcome of trabeculectomy, Mosaed said.
“This really allows you a wide variety of procedures to choose from to help tailor your patient care to improve and optimize patient outcomes,” Mosaed said.
Compared with other procedures, ab interno trabeculotomy involves no implant-related complications, she said.
Long-term data from the last decade show that the procedure significantly reduces IOP from baseline and frequently reduces the need for IOP-lowering medications, Mosaed said.
Disclosure: Mosaed has no relevant financial disclosures.