Procedural treatments: Trabeculectomy

Abstract

In trabeculectomy, the initial conjunctival incision can be created either at the limbus or in the fornix. This results in two different surgical approaches: (a) a limbal-based conjunctival flap (LBCF) - incision is deep in the fornix with the base at the limbus and (b) a fornix-based conjunctival flap (FBCF) - incision is at the limbus with the base in the fornix. Cairns introduced the LBCF in his original description of trabeculectomy [1]. The FBCF was suggested later by Luntz in 1980 [2]. Luntz's aim was to have a surgical approach that offered better visualization of the scleral flap during construction, and he felt that the FBCF resulted in more posteriorly located blebs. Bleb characteristics that are considered desirable include a low, diffuse profile, flow that is directed posteriorly over a large surface area, and some vascularity, so that the bleb does not break down easily. © 2010 Springer-Verlag Berlin Heidelberg.