Trabectome Patient Selection, Preparation, Technique, Management, and Outcomes

Abstract

Ab internotrabeculectomy with the Trabectome® (NeoMedix, Tustin, CA, US) is a minimally invasive glaucoma surgery that has the capacity to significantly lower intraocular pressure (IOP) with a highly favorable safety profile compared with traditional glaucoma surgeries. Since the first results were reported in 2005, mostly for primary open-angle glaucoma, the indications have since expanded to include secondary open- and closed-angle glaucoma. Exclusion criteria are active neovascular and uveitic glaucoma, and glaucoma due to increased episcleral pressure. On average, IOP is typically lowered by 30–40 % into the midteens, while decreasing the number of medications by one. Postoperative IOP can be estimated using a calculator. Patients with a higher preoperative IOP have the largest IOP reduction. Transient hyphema is a common postoperative observation. In this article, we will review surgical technique, patient management, postoperative care, and outcomes.