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December 1975

Trabeculectomy for Glaucoma-Reply

Author Affiliations

Washington, DC
Miami, Fla

Arch Ophthalmol. 1975;93(12):1372. doi:10.1001/archopht.1975.01010020994012

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In Reply.  —We appreciate Dr Back's interest in our article. His letter raises two points.The first is in regard to the need to localize exactly the Schlemm canal and the trabecular meshwork. Our point was that since a trabeculectomy works by filtration and not by having aqueous pass through the cut ends of the Schlemm canal, it is not necessary to have the Schlemm canal in the excisional space. However, we agree with Dr Back that one should be in the general area of the filtration meshwork. If one's dissection is too far toward the posterior side, the ciliary body may be encountered with bleeding, vitreous loss, or an inadvertent cyclodialysis as complications. If it is too far anteriorly, corneal problems may develop.In response to his second point, our usual scleral flap is about 5 mm × 5 mm and the tissue excised is usually a 1 mm×4

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