Israeli researchers at a company called IOPtima claim to have developed a safer, easier method to treat glaucoma using a CO2 laser. Since CO2 lasers have the inherent property of losing effectiveness when in contact with liquid, the full penetration of the sclera by mistake is almost impossible.
In recent years, a new and safer surgical procedure -- the non-penetrating trabeculectomy (deep sclerectomy) -- has been developed. In this procedure a thin layer of tissue is left behind. The main advantage of this technique, if properly performed, is that almost all complications such as those found with the conventional trabeculectomy are avoided. The main drawback, however, is that it demands careful and delicate surgery, relatively long learning curve, performed only by highly skilled surgeons, this, to avoid penetrating the anterior chamber -- the most common complication in this type of surgery. And should this occur, then this non-penetrating procedure, as it were, becomes a conventional penetrating trabeculectomy with all its disadvantages.
IOPtima has developed an innovative approach to the non-penetrating trabeculectomy -- CO2 Laser Non-Penetrating Deep Sclerectomy (LNPDS).
Based on IOPtima's unique CO2 Laser Filtration System -- OT133, the non-penetrating trabeculectomy can be performed easily, safely and successfully -- by any eye surgeon.
Trabeculectomy is the standard filtration surgery for glaucoma. In this operation, a filtering system is created by making a hole in the sclera of the eye, which then drains the intraocular fluid through superficial ocular tissue. Numerous postoperative complications may occur however, so the non-penetrating filtration procedure is therefore gaining widespread popularity. In this procedure a thin layer of membrane is left behind -- allowing for the free fluid percolation, or oozing, through this remaining tissue -- producing the desired effect. When done properly, by a highly skilled surgeon, the anterior chamber of the eye is not penetrated, decreasing significantly the incidences of early postoperative complications.
The procedure involves dissecting the scleral tissue to approximately 95% (of its depth), leaving a residual intact layer of only several dozen microns. Inadvertent perforation of the thin trabecular membrane is a frequent complication, occurring in as many as 30%-50% of the cases at the beginning of the learning curve. If, on the other hand, the tissue is not cut deep enough, filtration may not be effective enough to reduce intraocular pressure to the desired level. This conventional procedure is very demanding and requires great skill and vast experience.