Endoscopic Goniotomy

Abstract

Usually an elevated drainage resistance is responsible for elevated intraocular pressure (IOP) in glaucoma, while aqueous humor production is still normal. Therefore, currently there are great efforts to develop surgical techniques that enhance the conventional outflow through the trabecular meshwork and Schlemm’s canal and into the episcleral veins. One of these techniques is excimer laser trabeculotomy (ELT). ELT is easy to perform at the end of cataract surgery. The duration of cataract surgery is only prolonged by 2–3 minutes. IOP can be reduced by up to 34.7 %. It is known that the effect of IOP reduction is constant over time, unlike argon or selective laser trabeculoplasty. The procedure is also very safe. If required later, filtering surgery is not compromised because there is no conjunctival touch during ELT and therefore no scarring of the conjunctiva is induced. For a selected cohort of glaucoma patients, this procedure may avoid the need for trabeculectomy.