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Microhook ab interno trabeculotomy, a novel minimally invasive glaucoma surgery

Authors Tanito M

Received 23 September 2017

Accepted for publication 16 November 2017

Published 20 December 2017 Volume 2018:12 Pages 43—48

DOI https://doi.org/10.2147/OPTH.S152406

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Masaki Tanito

Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan

Abstract: Trabeculotomy (LOT) is performed to reduce the intraocular pressure in patients with glaucoma, both in children and adults. It relieves the resistance to aqueous flow by cleaving the trabecular meshwork and the inner walls of Schlemm’s canal. Microhook ab interno LOT (µLOT), a novel minimally invasive glaucoma surgery, incises trabecular meshwork using small hooks that are inserted through corneal side ports. An initial case series reported that both µLOT alone and combination of µLOT and cataract surgery normalize the intraocular pressure during the early postoperative period in Japanese patients with glaucoma. Microhook can incise the inner wall of Schlemm’s canal without damaging its outer wall easier than the regular straight knife that is used during goniotomy. Advantages of µLOT include: a wider extent of LOT (two-thirds of the circumference), a simpler surgical technique, being less invasiveness to the ocular surface, a shorter surgical time than traditional ab externo LOT, and no requirement for expensive devices. In this paper, the surgical technique of µLOT and tips of the technique are introduced.

Keywords: trabecular meshwork, Schlemm’s canal, intraocular pressure, surgical procedure, glaucoma

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