[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
October 1995

Is Laser Sclerostomy Surgery Ready for 'Prime Time'?

Author Affiliations

Baltimore, Md

Arch Ophthalmol. 1995;113(10):1243-1244. doi:10.1001/archopht.1995.01100100031022

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


There are many controversial areas within ophthalmology, and undoubtedly the field of glaucoma carries its lion's share. Consider filtration surgery as an area replete with debatable issues. The technique of conventional filtration surgery varies among surgeons, so comparing one series of patients with another becomes difficult. The differences in defining success adds another layer of complexity when comparing outcomes. It is particularly difficult to determine the usefulness of new procedures that can be performed using several different wavelengths, multiple approaches, and various choices of adjunctive medications to enhance the success of the technique. The term laser sclerostomy has a high-tech ring and may in the future be performed in every ophthalmic office in the country. However, is this procedure ready for "prime time" now? Is it ready for the first line of surgical intervention?

There are several approaches that we are lumping together within this term. There are internal and

Higginbotham EJ, Kao G, Peyman G.  Internal sclerostomy with the Nd:YAG contact laser versus thermal sclerostomy in rabbits . Ophthalmology . 1988;95:385-390.Article
Higginbotham EJ, Zou X, Edward D.  Internal sclerostomy with the Nd:YAG contact laser versus thermal sclerostomy in cynomolgus monkeys . Laser Light Ophthalmol . 1990;3:281-286.
Jaffe GJ, Mieler WF, Radius RL, et al.  Ab-interno sclerostomy with a high-powered argon endolaser . Arch Ophthalmol . 1989;107:1183-1185.Article
March WF, Bernitzky D, Gherezghiher T, et al.  Creation of filtering blebs with the YAG laser in primates and rabbits . Glaucoma . 1985;7:43-45.
Melamed S, Solomon A, Neumann D, et al.  Internal sclerostomy using laser ablation of dyed sclera in glaucoma patients: a pilot study . Br J Ophthalmol . 1993;77:139-144.Article
Brown RH, Lynch MG, Denham DB, et al.  Internal sclerectomy with an automated trephine for advanced glaucoma . Ophthalmology . 1988;95:728-734.Article
Iwach AG, Hoskins HD, Drake MV, Dickens CJ.  Update of the subconjunctival THC:YAG (holmium) laser sclerostomy ab externo clinical trial: 30-month report . Ophthalmic Surg . 1994;25:13-21.
Fliegler RJ, Mastrobattista J, Luntz MH.  Subconjunctival THC:YAG laser sclerostomy under a partial-thickness corneal flap . Ophthalmic Surg . 1994;25:28-33.
Aron-Rosa D, Maden A, Ganem S, et al.  Preliminary study of argon fluoride (193 nm) excimer laser trabeculectomy: scanning electron microscopy at five months . J Cataract Refract Surg . 1990;16:617-620.Article
Karp CL, Higginbotham EJ, Edwards DP, et al.  Diode laser surgery: ab interno and ab externo versus conventional surgery in rabbits . Ophthalmology . 1993;100:1567-1573.Article
Berlin M, Martinez M, Peter-Loercher H.  Erbium YAG laser sclerostomy, mechanism and histological analysis . Invest Ophthalmol . 1991;32( (suppl) ):860.
Beckman H, Fuller TA.  Carbon dioxide laser scleral dissection and filtering procedure for glaucoma . Am J Ophthalmol . 1979;88:73-79.
Broadway DC, Grierson I, O'Brien C, Hitchings RA.  Adverse effects of topical antiglaucoma medication, II: the outcome of filtration surgery . Arch Ophthalmol . 1994;112:1446-1454.Article
Scheie HG.  Goniopuncture: a new filtering operation for glaucoma . Arch Ophthalmol . 1950;44:761-763.Article
Krasnov MM.  Laser puncture of anterior chamber angle in glaucoma . Am J Ophthalmol . 1973;75:674-678.
Kozart DM, Cameron SD.  Goniodiathermy: experimental studies on ab interno filtration . Ann Ophthalmol . 1978;14:1597-1598.
Brown SVL, Higginbotham EJ, Griffen EO, et al.  Ab-interno sclerostomy using a goniodiathermy instrument . Ophthalmic Surg . 1994;25:112-116.
Schuman JJ, Stinson WG, Hutchinson T, et al.  Holmium laser sclerectomy . Ophthalmology . 1993;100:1060-1065.Article
Saheb NE.  Short-term results of holmium laser sclerostomy in patients with uncontrolled glaucoma . Can J Ophthalmol . 1993;28:317-319.
Bonomi L, Perfett S, Marratta M, et al.  Subconjunctival THC:YAG laser sclerostomy for the treatment of glaucoma: preliminary data . Ophthalmic Surg . 1993;24:300-303.
The Fluorouracil Filtering Surgery Study Group.  Three-year follow-up of the Fluorouracil Filtering Study . Am J Ophthalmol . 1993;115:82-92.
Katz GH, Higginbotham EJ, Lichter PR, et al.  Mitomycin-C versus 5-fluorouracil in high-risk glaucoma filtering surgery: extended follow-up . Invest Ophthalmol Vis Sci . 1994;35( (suppl) ):1428.