EyeWorld Asia-Pacific December 2021 Issue

GLAUCOMA 40 EWAP DECEMBER 2021 T hough the trabeculectomy procedure is more than 50 years old, it is still considered to be the gold standard in glaucoma surgery. Even with new devices and techniques, particularly many microinvasive options, trabeculectomy is able to produce the best pressure-lowering effect. Leon Herndon Jr., MD, and Douglas Rhee, MD, discussed the history of trabeculectomy, how it has evolved, and how it fits into the glaucoma treatment paradigm. Dr. Herndon said he thinks trabeculectomy is still the gold standard of glaucoma surgery. “If you need a low pressure, there’s nothing that comes close to the lowering effect of trabeculectomy,” he said. According to Dr. Rhee, the procedure is attributed to H. Saul Sugar, MD. Though he noted that the concept of having an open hole in the eye to drain fluid has Leen around since 1830, Dr. Sugar wrote about a progenitor of modern trabeculectomy in 1961, 1 and J.E. Cairns, FRCS, later published on the method and reported on a guarded filtration procedure in 1968. 2 Dr. Cairns popularized trabeculectomy, Dr. Herndon said. Before this, there were full thickness procedures, essentially making a hole in the eye with no cover. “Dr. Cairns decided to make a guarded trabeculectomy Examining trabeculectomy by Ellen Stodola Editorial Co-Director Dr. Herndon performs a trab EX-PRESS Glaucoma Filtration Device procedure. Source (all): Leon Herndon, MD Contact information Herndon: leon.herndon@duke.edu Rhee: dougrhee@aol.com This article originally appeared in the September 2021 issue of EyeWorld . It has Leen slightlÞ modified and appears here with permission from the ASCRS Ophthalmic Services Corp.