Trabeculectomy vs. nonpenetrating trabeculectomy: a retrospective study of two procedures in phakic patients with glaucoma.

In a retrospective study we compared the efficacy and safety of trabeculectomy and nonpenetrating trabeculectomy (NPT). In the latter procedure under a thin scleral flap, juxtacanalicular trabecular meshwork with Schlemm's canal is excised leaving the innermost trabecular meshwork behind. Trabeculectomy was performed on 86 eyes (66 blacks, 20 whites), whereas 71 eyes underwent NPT (44 blacks, 27 whites). The mean follow-up period was 1.7 years. Postoperatively at one year, trabeculectomy controlled 70.3% of patients with no or topical antiglaucoma medication, whereas 83.7% of NPT patients were similarly controlled. There was a difference in the number and severity of complications between trabeculectomy and NPT. Postoperative flat anterior chamber, uveitis, hyphema, vitreous loss, and choroidal detachment occurred more frequently after trabeculectomy.

Effectiveness of nonpenetrating trabeculectomy in aphakic patients with glaucoma.

Nonpenetrating trabeculectomy was performed on 28 aphakic eyes consisting of 18 with chronic open-angle glaucoma and 10 with secondary and/or complicated glaucoma. The canal of Schlemm and the juxtacanalicular trabecular meshwork were excised for a length of 4 mm beneath a 6 mm x 6 mm scleral flap. At one year postoperatively, 72.0% of all patients were controlled, 24% required no antiglaucoma medications. However, 88% of chronic simple glaucoma patients were satisfactorily controlled. The mean follow-up period was 1.4 years. Minimal complications have been encountered to date. Nonpenetrating trabeculectomy may be valuable as an initial procedure in aphakic patients who require glaucoma filtration surgery.