Ab-Interno Trabeculotomy

Abstract

Abstract The Trabectome (NeoMedix Corporation, San Juan Capistrano, CA, USA) is a US Food and Drug Administration—approved surgical device which removes a segment of the trabecular meshwork and the inner wall of the Schlemm’s canal using an ab-interno approach, enhancing aqueous outflow via increased access to the Schlemm’s canal and the collector channels. This is a bleb-less procedure which spares the conjunctiva, hence does not adversely affect the outcome of subsequent conventional glaucoma filtration surgeries. Multiple studies have shown that Trabectome surgery results in a reduction in IOP and the number of ocular hypotensive agents, though the efficacy is modest compared with conventional filtration surgery. The safety profile of Trabectome surgery is favorable compared with conventional glaucoma surgery, with the most common complication being intraoperative and postoperative bleeding. Additional research is required to understand how the efficacy of Trabectome surgery can be maximized.