This retrospective study examines the outcome of trabectome surgery in nine phakic patients with Posner-Schlossman syndrome with uncontrolled IOP >30mmgHg. Cytomegalovirus (CMV) DNA was verified by polymerase chain reaction (PCR) in aqueous humour samples. Patients were treated with oral valganciclover prior to surgery which was extended to three months after surgery. The procedure was carried out via a 1.6mm temporal limbal incision and selective electrosurgical abalation was activated to remove 120 degree arc of trabecular meshwork and the inner wall of Schlemm’s canal. Mean IOP before trabectome surgery was 40±10 mmHg (range 33-58 mmHg). The mean number of antiglaucoma medications prior to surgery was 3.1±0.4. By the end of the 12 months, IOP in all patients was reduced to normal level (13±1 mmHg) and their anti-glaucoma medications were decreased to 0.8±1.1. Intraoperative complication of blood reflux occurred in all seven patients. No recurring attack of glaucomatocyclitic crisis occurred. Limitations of the study include small cohort and short follow-up period. 

Trabeculectomy ab interno (Trabectome) yet another possibility in the treatment of uncontrolled glaucomatocyclitic crises under systemic ganciclovir therapy.
Pahlitzsch M, Torun N, Gonnermann J, et al.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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