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August 1965

Goniotomy—a Modified Lens and Technique

Author Affiliations

Portland, Ore
From the University of Oregon Medical School.

Arch Ophthalmol. 1965;74(2):231-234. doi:10.1001/archopht.1965.00970040233020

Goniotomy is the procedure of choice in early, uncomplicated congenital and infantile glaucoma. The operation was used by De Vencentis in 1893, but Otto Barkan really established its effectiveness and developed a method for performing the operation under direct vision and with magnification.1 The technique which he described more than 30 years ago still is widely used, although many ophthalmologists find the unconventional operating position alongside the patient awkward and are dissatisfied with Barkan's lens. As a result, some experienced surgeons stand at the conventional operating position at the head of the table and perform the operation without a lens. This may be effective; however, postgoniotomy examination of eyes operated without good visualization of the angle, by capable surgeons, occasionally has revealed synechiae, iridotomies, corneal scarring, and even injury to the lens. For example, one child was referred to the University of Oregon Medical School after bilateral goniotomies had

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