My procedure and antimetabolite dose of choice for a primary trabeculectomy

摘要

Dr Higginbotham: This was supposed to be a panel on antimetabolites and how we do our trabeculectomy surgery. I could share with you, at least, a tape of one trabeculectomy technique and then we can talk about dosages as well as the questions and answers. This is a patient who has had multiple surgeries. I'd just like to highlight the fact that you have a lot of scarring, and the first step is to choose an appropriate surgical site. This is a patient who had uveitis, had had previous glaucoma surgery as a child, and was aphakic. So she had multiple risk factors for trab failure, as well as being African American. As we took our excursion around the limbus, we chose the most mobile site. The first thing I like to do, since I am often operating on patients who have significant scarring, is to balloon the conjunctiva. I balloon the conjunctiva with 1% lidocaine with epinephrine. This serves