FIGURE 2.

The four major steps in Trabectome surgery for open-angle glaucoma. Top left, A clear corneal near-limbal 1.6-mm keratome incision is made. Top right, Viscoelastic may or may not be necessary to allow safe insertion of the instrument tip to allow infusion flow and anterior chamber stability. Bottom left, Surgical tip is advanced under gonioscopic control to engage nasal meshwork before activating aspiration and ablation by progressively depressing the foot pedal and rotating the tip parallel to the iris just anterior to the scleral spur. Bottom right, Ablation with continual infusion and aspiration is performed along an arc of 30° to 60° to ensure complete viscoelastic removal thereafter.