The experience of recent years has shown that trabeculotomy ab externo is a valid and safe technique for the surgical treatment of congenital and open-angle glaucoma; however, in some cases, after a variable period of time, the surgical opening closes with consequent loss in effectiveness of the operation. Diathermo-trabeculotomy has been devised to avoid this complication. It is based on the concept that diathermy delays or prevents the normal process of scar tissue formation. A trabeculotome has been designed which acts as an electric scalpel on the inner wall of Schlemm's canal.
The theoretical basis of diathermo-trabeculotomy ab externo is the concept that the diathermic effect prevents or delays the normal processes of scar formation in the tissues. By applying this concept in the field of ocular microsurgery we have associated this effect of diathermy with the traditional operation of trabeculotomy so as to avoid closure of the surgical opening, which often reduces the effectiveness of the operation after an interval of time.The problem has been solved by a trabeculotome suitably insulated except for the part which comes into contact with the canal wall on the trabecular meshwork side.
Methods and materialThe technical data and the operating technique have been published in this journal (Maselli et al., 1975).With this technique we have operated on 47 eyes, 35 of which were affected with chronic simple glaucoma, 10 with congenital glaucoma, and 2 with closed-angle glaucoma.
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