Endoscopic goniotomy: a potential surgical procedure for primary infantile glaucoma

Karen Margaret Joos M.D.; Wallace L. M. Alward M.D.; Robert Folberg M.D.

doi:10.1117/12.147530

24 June 1993 Endoscopic goniotomy: a potential surgical procedure for primary infantile glaucoma

Karen Margaret Joos M.D., Wallace L. M. Alward M.D., Robert Folberg M.D.

Proceedings Volume 1877, Ophthalmic Technologies III; (1993) https://doi.org/10.1117/12.147530
Event: OE/LASE'93: Optics, Electro-Optics, and Laser Applications in Scienceand Engineering, 1993, Los Angeles, CA, United States

Abstract

Goniotomy is an effective treatment for primary infantile glaucoma. Unlike trabeculotomy, goniotomy facilitates the visualization of the trabecular meshwork and does not disturb the conjunctiva. Because a cloudy cornea may prevent a clear view of the anterior chamber angle through the operating microscope, we investigated whether an endoscope would improve visualization during goniotomy in pig cadaver eyes. We deepened the anterior chamber of each pig eye with viscoelastic material. A modified 23-gauge needle attached to an Olympus 0.8 mm diameter flexible fiberoptic endoscope entered the anterior chamber through a 3 mm limbal incision. The angle was clearly seen on a videoscreen as the needle approached and incised the trabecular pillars for 120 degree(s); the iris immediately fell back. Following the procedure, the eyes were fixed in formalin and sectioned for light microscopy, or fixed in 2% glutaraldehyde for scanning electron microscopy. Trabecular pillars were present from the iris root to Schwalbe's line in the untreated region of the anterior chamber angle. The treated area demonstrated incision of the trabecular pillars with opening of the underlying trabecular meshwork.

Citation Download Citation

Karen Margaret Joos M.D., Wallace L. M. Alward M.D., and Robert Folberg M.D. "Endoscopic goniotomy: a potential surgical procedure for primary infantile glaucoma", Proc. SPIE 1877, Ophthalmic Technologies III, (24 June 1993); https://doi.org/10.1117/12.147530

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