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Taiwan J Ophthalmol. 2019 Apr-Jun;9(2):67-71. doi: 10.4103/tjo.tjo_38_19.

Ab-interno trabeculotomy-related glaucoma surgeries.

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Department of Ophthalmology, Faculty of Medicine, Shimane University, Shimane Prefecture, Japan.


Reductions of intraocular pressure during trabeculotomy result from relieving the resistance to aqueous flow by cleavage of the trabecular meshwork and inner walls of Schlemm's canal at the point of outflow resistance of the aqueous humor. Since trabeculotomy does not result in bleb formation, development of late-onset sight-threatening complications, such as hypotony maculopathy and endophthalmitis, that are associated occasionally with trabeculectomy develop less frequently after trabeculotomy. The ab-interno approach is used in several new procedures, including the Trabectome, Kahook Dual Blade, microhook abinterno trabeculotomy, and 360° suture trabeculotomy, instead of the ab-externo approach as in conventional trabeculotomy. These newly developed novel, minimally invasive, and trabeculotomy-related glaucoma surgeries can be good options for certain glaucoma cases, including early-stage open-angle glaucoma, developmental glaucoma, and glaucoma in elderly patients.


Ab-externo trabeculotomy; Kahook Dual Blade; Trabectome; microhook ab-interno trabeculotomy; minimally invasive glaucoma surgery; suture ab-interno trabeculotomy

Conflict of interest statement

The microhooks used were codeveloped by Masaki Tanito, MD, PhD, and Inami and Co., Ltd. (Tokyo, Japan) and provided by Inami and Co., Ltd. Dr. Tanito receives royalties from Inami and Co., Ltd.

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