Nick Strouthidis MBBS MD PhD FRCS FRCOphth FRANZCO

NON-PENETRATING SURGERY

There is a variant of glaucoma surgery called 'non-penetrating surgery' which can be considered for the same indications as trabeculectomy.

Advocates of this technique believe that it carries less risk than trabeculectomy because it may be less likely to cause hypotony or infection. Recent studies of modern trabeculectomy techniques (Kirwan, et al. Ophthalmology 2013) have, however, shown that these risks are very rare in skilled hands.

The argument against non-penetrating surgery is that it may not achieve the same low target pressures as trabeculectomy so may not be suitable in cases where the glaucoma is deteriorating despite relatively low IOP.

A new variation of non-penetrating surgery whereby part of the surgical dissection is carried out using a CO2 laser will be trialled at Moorfields Eye Hospital later in 2014, with Mr Strouthidis being one of the investigators.