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December 1975

Trabeculectomy for Glaucoma

Author Affiliations

Spring Valley, NY

Arch Ophthalmol. 1975;93(12):1372. doi:10.1001/archopht.1975.01010020994011

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To the Editor.  —In the August issue of the Archives (92:134, 1974), Schwartz and Anderson presented the results of trabeculectomies performed for different types of glaucoma.I wish to disagree with the statement that "the precise location of the excision of the trabecular meshwork and Schlemm's canal may not be necessary." Excising sclera over the ciliary body behind the insertion of the iris root is ineffective, since the ciliary body blocks the newly created escape route. On the other hand, excising corneal tissue anterior to the Schwalbe line can lead to corneal edema and refractive complications. For this reason, the only site left for excision is the filtration area.The authors fail to mention the extent and thickness of tissue excised. If the increase of resistance to out-flow is based on a sclerosing process involving not only the trabecular meshwork but possibly the overlying sclera, enough tissue in length and

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