Limbal lip cautery establishes a permanent filtering tract between the anterior chamber and the subconjunctiva. The tract becomes lined by spongy tissue formed in the healing process. The procedure varies somewhat in different types of glaucoma. In all instances it essentially consists of application of the cautery to the cut surfaces or lips of a groove made by a knife incision through three fourths of the limbus tissue. There may be more indications for limbal lip cautery than for scleral cautery because of the lesser amount of cautery and the smaller initial opening into the anterior chamber.
Limbal lip cautery is particularly useful for the surgical management of infantile1 and aphakic glaucoma. It may be employed to enhance the effect of iridencleisis in uncontrolled angle-closure glaucoma,2 and may be combined with intracapsular cataract extraction in chronic open-angle glaucoma with cataract.
Although the length and position of the groove must be
MacLEAN AL. Limbal Lip Cautery for Glaucoma. Arch Ophthalmol. 1964;71(5):653-661. doi:10.1001/archopht.1964.00970010669011