Trabectome

Trabectome is a surgical device that removes the trabecular meshwork and opens access to the Schlemm's canal

Trabectome is a surgical device that can be used for Ab interno trabeculotomy, a minimally invasive glaucoma surgery for the surgical management of adult, juvenile and infantile glaucoma. Unlike trabeculectomy, the surgery does not create an external filtering bleb. Instead, the Trabectome handpiece opens access to Schlemm's canal by ablating the trabecular meshwork of the eye, therefore reducing intraocular pressure which is major risk factor for glaucomatous vision loss. The irrigation/aspiration device provides irrigation during surgery and collection of residual fluid and ablated tissue in a collection bag. This procedure is performed through a small incision and can be done on an outpatient basis.[1]

This device was invented by George Baerveldt at the University of California, Irvine and has been manufactured by the NeoMedix Corporation in Tustin, California.

The images below illustrate how Trabectome improves aqueous drainage by removing the damaged trabecular meshwork.

Trabectome decreases intra-ocular pressure to mid-teen range and reduces patient's requirement to take glaucoma eye drops and glaucoma medications (see references).

Currently, there are no published studies that compare outcomes for efficacy and safety of Trabectome to other procedures for treating glaucoma.[2]

References

Vold SD, Dustin L, and the Trabectome Study Group. Impact of laser trabeculoplasty on Trabectome® outcomes. Ophthalmic Surg Lasers Imaging. 2010 Jul-Aug;41(4):443-51. {{doi|10.3928/15428877-20100525-06}}. Epub 2010 May 28.</ref>

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  1. ↑ http://www.glaucoma.org/treatment/the-future-of-glaucoma-surgery.php
  2. ↑ Hu K, Gazzard G, Bunce C, Wormald R (2016). "Ab interno trabecular bypass surgery with Trabectome for open angle glaucoma". Cochrane Database Syst Rev. 8: CD011693. PMID 27526051. doi:10.1002/14651858.CD011693.pub2.
  3. ↑ Vizzeri G, Weinreb RN. Cataract surgery and glaucoma. Curr Opin Ophthalmol. 2010 Jan;21(1):20-4. Review.
  4. ↑ Mosaed S, Dustin L, Minckler DS. Comparative outcomes between newer and older surgeries for glaucoma. Trans Am Ophthalmol Soc. 2009 Dec;107:127-33. Review.
  5. ↑ Liu J, Jung J, Francis BA. Ab interno trabeculotomy: Trabectome™ surgical treatment for open-angle glaucoma. Expert Rev Ophthalmol.2009;4(2):119-128.
  6. ↑ Minckler DS, Hill RA. Use of novel devices for control of intraocular pressure. Exp Eye Res. 2009 Apr;88(4):792-8. Epub 2008 Nov 30. Review.
  7. ↑ Patel SP, Sit AJ. A practical model for trabecular meshwork surgery. Arch Ophthalmol. 2009 Mar;127(3):311-3.
  8. ↑ Godfrey DG, Fellman RL, Neelakantan A. Canal surgery in adult glaucomas.Curr Opin Ophthalmol. 2009 Mar;20(2):116-21. Review.
  9. ↑ Minckler D, Mosaed S, Dustin L, Francis B, and the Trabectome Study Group. Trabectome (trabeculectomy – internal approach): Additional experience and extended follow-up. Trans Am Ophthalmol Soc 2008;106:149-160.
  10. ↑ Nguyen QH. Trabectome: a novel approach to angle surgery in the treatment of glaucoma. Int Ophthalmol Clin. 2008 Fall;48(4):65-72. Review.
  11. ↑ Francis BA, Minckler D, Dustin L, Kawji S, Yeh J, Sit A, Mosaed S, Johnstone M; Trabectome Study Group. Combined cataract extraction and trabeculotomy by internal approach for coexisting cataract and open-angle glaucoma. J Cataract Refract Surg. 2008 Jul;34(7):1096-103.
  12. ↑ Filippopoulos T, Rhee D. Novel surgical procedures in glaucoma. Advances in penetrating glaucoma surgery. Curr Opin Ophthalmol. 2008 Mar;19(2):149-54. Review.
  13. ↑ Gunderson E. Trabeculotomy Ab Interno, using the Trabectome: a promising treatment for patients with open-angle glaucoma. Insight. 2008 Jan-Mar;33(1):13-15.
  14. ↑ Mosaed S. Ab interno trabeculotomy with the Trabectome surgical device. Techniques in Ophthalmology: 5(2):63-66, 2007.
  15. ↑ Francis BA, See RF, Rao NA, Minckler DS, Baerveldt G. Ab interno trabeculectomy: development of a novel device (Trabectome™) and surgery for open-angle glaucoma. J Glaucoma. 2006 Feb;15(1):68-73.
  16. ↑ Minckler D, Baerveldt G, Ramirez MA, Mosaed S, Wilson R, Shaarawy T, Zack B, Dustin L, Francis B. Clinical results with the Trabectome, a novel surgical device for the treatment of open-angle glaucoma. Trans Am Ophthalmol Soc. 2006;104:40-50.
  17. ↑ Minckler DS, Baerveldt G, Alfaro MR, Francis BA. Clinical results with the Trabectome for treatment of open-angle glaucoma. Ophthalmology. 2005 Jun;112(6):962-7.
  18. ↑ Vold SD, Dustin L, and the Trabectome Study Group. Impact of laser trabeculoplasty on Trabectome® outcomes. Ophthalmic Surg Lasers Imaging. 2010 Jul-Aug;41(4):443-51. doi:10.3928/15428877-20100525-06. Epub 2010 May 28.
  19. ↑ Vizzeri G, Weinreb RN. Cataract surgery and glaucoma. Curr Opin Ophthalmol. 2010 Jan;21(1):20-4. Review.
  20. ↑ Mosaed S, Dustin L, Minckler DS. Comparative outcomes between newer and older surgeries for glaucoma. Trans Am Ophthalmol Soc. 2009 Dec;107:127-33. Review.
  21. ↑ Liu J, Jung J, Francis BA. Ab interno trabeculotomy: Trabectome™ surgical treatment for open-angle glaucoma. Expert Rev Ophthalmol.2009;4(2):119-128.
  22. ↑ Minckler DS, Hill RA. Use of novel devices for control of intraocular pressure. Exp Eye Res. 2009 Apr;88(4):792-8. Epub 2008 Nov 30. Review.
  23. ↑ Patel SP, Sit AJ. A practical model for trabecular meshwork surgery. Arch Ophthalmol. 2009 Mar;127(3):311-3.
  24. ↑ Godfrey DG, Fellman RL, Neelakantan A. Canal surgery in adult glaucomas.Curr Opin Ophthalmol. 2009 Mar;20(2):116-21. Review.
  25. ↑ Minckler D, Mosaed S, Dustin L, Francis B, and the Trabectome Study Group. Trabectome (trabeculectomy – internal approach): Additional experience and extended follow-up. Trans Am Ophthalmol Soc 2008;106:149-160.
  26. ↑ Nguyen QH. Trabectome: a novel approach to angle surgery in the treatment of glaucoma. Int Ophthalmol Clin. 2008 Fall;48(4):65-72. Review.
  27. ↑ Francis BA, Minckler D, Dustin L, Kawji S, Yeh J, Sit A, Mosaed S, Johnstone M; Trabectome Study Group. Combined cataract extraction and trabeculotomy by internal approach for coexisting cataract and open-angle glaucoma. J Cataract Refract Surg. 2008 Jul;34(7):1096-103.
  28. ↑ Filippopoulos T, Rhee D. Novel surgical procedures in glaucoma. Advances in penetrating glaucoma surgery. Curr Opin Ophthalmol. 2008 Mar;19(2):149-54. Review.
  29. ↑ Gunderson E. Trabeculotomy Ab Interno, using the Trabectome: a promising treatment for patients with open-angle glaucoma. Insight. 2008 Jan-Mar;33(1):13-15.
  30. ↑ Mosaed S. Ab interno trabeculotomy with the Trabectome surgical device. Techniques in Ophthalmology: 5(2):63-66, 2007.
  31. ↑ Francis BA, See RF, Rao NA, Minckler DS, Baerveldt G. Ab interno trabeculectomy: development of a novel device (Trabectome™) and surgery for open-angle glaucoma. J Glaucoma. 2006 Feb;15(1):68-73.
  32. ↑ Minckler D, Baerveldt G, Ramirez MA, Mosaed S, Wilson R, Shaarawy T, Zack B, Dustin L, Francis B. Clinical results with the Trabectome, a novel surgical device for the treatment of open-angle glaucoma. Trans Am Ophthalmol Soc. 2006;104:40-50.
  33. ↑ Minckler DS, Baerveldt G, Alfaro MR, Francis BA. Clinical results with the Trabectome for treatment of open-angle glaucoma. Ophthalmology. 2005 Jun;112(6):962-7.
  34. ↑ Vold SD, Dustin L, and the Trabectome Study Group. Impact of laser trabeculoplasty on Trabectome® outcomes. Ophthalmic Surg Lasers Imaging. 2010 Jul-Aug;41(4):443-51. doi:10.3928/15428877-20100525-06. Epub 2010 May 28.
  35. ↑ Vizzeri G, Weinreb RN. Cataract surgery and glaucoma. Curr Opin Ophthalmol. 2010 Jan;21(1):20-4. Review.
  36. ↑ Mosaed S, Dustin L, Minckler DS. Comparative outcomes between newer and older surgeries for glaucoma. Trans Am Ophthalmol Soc. 2009 Dec;107:127-33. Review.
  37. ↑ Liu J, Jung J, Francis BA. Ab interno trabeculotomy: Trabectome™ surgical treatment for open-angle glaucoma. Expert Rev Ophthalmol.2009;4(2):119-128.
  38. ↑ Minckler DS, Hill RA. Use of novel devices for control of intraocular pressure. Exp Eye Res. 2009 Apr;88(4):792-8. Epub 2008 Nov 30. Review.
  39. ↑ Patel SP, Sit AJ. A practical model for trabecular meshwork surgery. Arch Ophthalmol. 2009 Mar;127(3):311-3.
  40. ↑ Godfrey DG, Fellman RL, Neelakantan A. Canal surgery in adult glaucomas.Curr Opin Ophthalmol. 2009 Mar;20(2):116-21. Review.
  41. ↑ Minckler D, Mosaed S, Dustin L, Francis B, and the Trabectome Study Group. Trabectome (trabeculectomy – internal approach): Additional experience and extended follow-up. Trans Am Ophthalmol Soc 2008;106:149-160.
  42. ↑ Nguyen QH. Trabectome: a novel approach to angle surgery in the treatment of glaucoma. Int Ophthalmol Clin. 2008 Fall;48(4):65-72. Review.
  43. ↑ Francis BA, Minckler D, Dustin L, Kawji S, Yeh J, Sit A, Mosaed S, Johnstone M; Trabectome Study Group. Combined cataract extraction and trabeculotomy by internal approach for coexisting cataract and open-angle glaucoma. J Cataract Refract Surg. 2008 Jul;34(7):1096-103.
  44. ↑ Filippopoulos T, Rhee D. Novel surgical procedures in glaucoma. Advances in penetrating glaucoma surgery. Curr Opin Ophthalmol. 2008 Mar;19(2):149-54. Review.
  45. ↑ Gunderson E. Trabeculotomy Ab Interno, using the Trabectome: a promising treatment for patients with open-angle glaucoma. Insight. 2008 Jan-Mar;33(1):13-15.
  46. ↑ Mosaed S. Ab interno trabeculotomy with the Trabectome surgical device. Techniques in Ophthalmology: 5(2):63-66, 2007.
  47. ↑ Francis BA, See RF, Rao NA, Minckler DS, Baerveldt G. Ab interno trabeculectomy: development of a novel device (Trabectome™) and surgery for open-angle glaucoma. J Glaucoma. 2006 Feb;15(1):68-73.
  48. ↑ Minckler D, Baerveldt G, Ramirez MA, Mosaed S, Wilson R, Shaarawy T, Zack B, Dustin L, Francis B. Clinical results with the Trabectome, a novel surgical device for the treatment of open-angle glaucoma. Trans Am Ophthalmol Soc. 2006;104:40-50.
  49. ↑ Minckler DS, Baerveldt G, Alfaro MR, Francis BA. Clinical results with the Trabectome for treatment of open-angle glaucoma. Ophthalmology. 2005 Jun;112(6):962-7.
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