Surgical procedure used in the treatment of glaucoma to relieve IOP by removing part of the eye's trabecular meshwork and adjacent structures :: most common INVASIVE glaucoma Sx::
Allows drainage of aqueous humor from within the eye to underneath the conjunctiva where it is absorbed.
Procedure:
1. initial pocket is created under the conjunctiva and Tenon's capsule and the wound bed is treated for several seconds to minutes with mitomycin C (MMC, 0.5–0.2 mg/ml) or 5-fluorouracil (5-FU, 50 mg/ml) soaked sponges. why? to inhibit fibroblast proliferation.
2. A partial thickness flap with its base at the corneoscleral junction is then made in the sclera after careful cauterization of the flap area
3. a window opening is created under the flap with a Kelly-punch to remove a portion of the sclera, Schlemm's canal and the trabecular meshwork to enter the anterior chamber
4. Because of the fluid egress the iris will partially prolapse through the sclerostomy and is usually therefore grasped to perform an excision called iridectomy.(This iridectomy will prevent future blockage of the sclerostomy)
5. The scleral flap is then sutured loosely back in place with several sutures. The conjunctiva is closed in a watertight fashion at the end of the procedure.
Characterized by the bleb on sclera/cornea and pressure can not be applied on the eye.
