IN 1968, the trabeculectomy procedure was introduced as a surgical treatment for glaucoma.1 Although this procedure was a major improvement to what was then available in the glaucoma surgical armamentarium, it has its limitations because of the need to enter the eye.
The past several decades have witnessed major advances in cataract surgery and vitreoretinal surgery. In stark contrast, there have been relatively minor advances in glaucoma surgery, and trabeculectomy remains the procedure of choice for most eyes with glaucoma requiring surgical treatment. One advance has been the adjunctive use of antifibrotic agents, such as fluorouracil and mitomycin, with trabeculectomy. These agents have improved the success rate of trabeculectomy, particularly in eyes at high risk for filtration failure. However, the need to enter the eye persists as does the potential complications, some of which are devastating.
M. Roy Wilson. A Need for Innovation in Glaucoma Surgery. Arch Ophthalmol. 2002;120(5):633. doi:10.1001/archopht.120.5.633