Building a safer trabeculectomy

摘要

In this issue of the BJO (p 44), Stalmans et al describe their clinical results of a new technique for trabeculectomy, originally described by Wells et al. In this modification of the traditional trabeculectomy procedure, there are three main alterations: (1) adjustable/removable sutures are placed along each lateral side of the trabeculectomy flap for intraoperative and postoperative adjustment; (2) an anterior chamber maintainer is placed to titrate the leakage from the trabeculectomy and to wash out inflammatory debris from the anterior chamber; and (3) a standardised excision is created using the Khaw punch instrument of 0.5 mm. The overall purported advantage of these changes is reduced complications related to early postoperative overfiltra-tion.