The long-term results of fistulising trabeculotomy in chronic open-angle glaucoma

Background : Fistulising trabeculotomy has been used for nearly 20 years to combine the minimally invasive surgery of trabeculotomy with production of a subconjunctival fistula.
Methods : The canal of Schlemm was unroofed 2mm on one side of a 3mm half-thickness scleral flap. A trabeculotomy probe was passed about 30° along the canal on the opposite side and rotated into the anterior chamber.
Results : Of 99 eyes of 74 patients, 35 eyes of 25 patients were available for follow-up at 10 or more years. The mean IOP was 14 ± 4 mmHg (range 7 to 23 mmHg) from a preoperative IOP of 29 ± 8 mmHg (17 to 60 mmHg). Results in 44 similar patients undergoing trabeculectomy and 44 undergoing fistulising trabeculotomy were very similar at five-year follow-up.
Conclusion : Fistulising trabeculotomy was effective for lowering intraocular pressure with a low complication rate and a large area of subconjunctival fistulisation.