Preclinical Investigation of Goniotomy Using Four Different Techniques.

To evaluate the tissue-level effects of goniotomy techniques on human trabecular meshwork (TM). Laboratory investigation. The TM from human cadaveric corneal rim tissue was treated using 4 techniques: (1) microvitreoretinal (MVR) blade; (2) 360° trabeculotomy with 5-0 prolene suture; (3) the Kahook Dual Blade (KDB) Glide The MVR blade exhibited incision of TM extending into the scleral wall. The TrabEx device removed a small portion of TM with large leaflet tissue remnants in all treated areas. 360° suture trabeculotomy resulted in incision of the TM proximate to Schwalbe's line with no excised tissue evident in all treated areas. Areas treated with the KDB Glide device resulted in nearly complete excision of TM without injury to surrounding tissues. The various methods used for performing goniotomy or trabeculotomy resulted in varying degrees of incision or excision of TM. Only the KDB Glide device resulted in reliable excision of TM with the other devices producing incision or variable excision of tissue. Clinical correlation is required to better understand the implications of the current findings when using these methods to lower intraocular pressure in eyes with glaucoma.

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© 2020 Ammar et al.

Déclaration de conflit d'intérêts

DA Ammar has received financial support from New World Medical for contract work through his employer. Malik Kahook is a consultant to New World Medical, SpyGlass Ophthalmics and Alcon. He receives patent royalties from Alcon, New World Medical, Johnson and Johnson Vision, Fluent Ophthalmics, SpyGlass Ophthalmics, ShapeTech and Aurea Medical. He also reports a patent US10327947B2 with royalties paid by New World Medical. Leonard K Seibold is a consultant to New World Medical and reports grants from Glaukos and Allergan, outside the submitted work. The authors report no other conflicts of interest in this work.