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The implant is inserted through the trabecular meshwork, thus bypassing resistance of aqueous flow through the tissue. However, other glaucoma surgeries, such as canaloplasty, have shown that mechanical dilation of Schlemm's canal is also associated with a reduction in intraocular pressure. [ 31 ]
Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye's trabecular meshwork and adjacent structures. It is the most common glaucoma surgery performed and allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed.
Tube-shunt surgery or drainage implant surgery involves the placement of a tube or glaucoma valves to facilitate aqueous outflow from the anterior chamber. [ 41 ] [ 46 ] [ 47 ] Trabeculopuncture uses a Q switched Nd:YAG laser to punch small holes in the trabecular meshwork.
Reoperation after failed trabeculectomy or tube shunt is very challenging. Trabectome surgery is a minimally invasive alternative to a repeat filter or shunt. Studies of patients undergoing trabectome surgery after a failed tube shunt have shown a statistically significant reduction in intraocular pressure after one year [42].
The first glaucoma drainage implant was developed in 1966. [2] Following on the success of the Molteno implant, several varieties of device have been developed from the original, the Baerveldt tube shunt, or the valved implants, such as the Ahmed glaucoma valve implant and the later generation pressure ridge Molteno implants.
Trabeculoplasty is a laser treatment for glaucoma. It is done on an argon laser equipped slit lamp, using a Goldmann gonioscope lens mirror. Specifically, an argon laser is used to improve drainage through the eye's trabecular meshwork, from which the aqueous humour drains.
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