Trabectome

Trabectome is a minimally invasive glaucoma surgery (MIGS) device and procedure used to treat open-angle glaucoma. The technique involves the use of a specialized device to remove a portion of the trabecular meshwork, the eye's drainage system, to improve the outflow of aqueous humor and reduce intraocular pressure (IOP). Trabectome surgery is typically recommended for patients whose glaucoma cannot be adequately controlled with eye drops or other less invasive treatments.

Procedure

During the Trabectome procedure, a small incision is made in the cornea to allow access to the trabecular meshwork. The Trabectome device, which combines an electrocautery system with irrigation and aspiration, is then inserted into the anterior chamber of the eye. The device ablates a segment of the trabecular meshwork and the adjacent inner wall of Schlemm's canal, creating a direct path for aqueous humor to exit the eye, thereby lowering intraocular pressure.

Indications

Trabectome surgery is indicated for patients with open-angle glaucoma, particularly those in whom medical therapy has failed to adequately control intraocular pressure, or for those who cannot tolerate glaucoma medications due to side effects. It is also considered for patients seeking a less invasive alternative to traditional glaucoma surgeries such as trabeculectomy or glaucoma drainage implants.

Advantages

The Trabectome procedure offers several advantages over traditional glaucoma surgeries:

• Minimally invasive with a rapid recovery time
• Reduced risk of complications compared to more invasive glaucoma surgeries
• Can be performed in conjunction with cataract surgery
• Repeatable if necessary

Risks and Complications

As with any surgical procedure, Trabectome surgery carries risks, although they are generally lower than those associated with more invasive glaucoma surgeries. Potential complications include:

• Hyphema (blood in the anterior chamber of the eye)
• Infection
• Transient increase in intraocular pressure
• Damage to adjacent eye structures

Outcomes

Clinical studies have shown that Trabectome surgery can effectively lower intraocular pressure in patients with open-angle glaucoma. The procedure is most successful in patients with mild to moderate glaucoma and can significantly reduce the need for glaucoma medications. However, some patients may still require medication or additional surgeries to achieve optimal intraocular pressure control.

Conclusion

Trabectome surgery represents an important advancement in the treatment of open-angle glaucoma, offering a minimally invasive option for patients who have not achieved optimal outcomes with medical therapy or who wish to avoid more invasive surgical options. As with any medical procedure, patients should discuss the potential risks and benefits of Trabectome surgery with their ophthalmologist to determine if it is the right choice for their specific condition.