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Quaranta L., Russo A., Noto F.
Course of Visual Apparatus Diseases, University of Brescia, Brescia, Italy, USVD “Centro per lo studio del Glaucoma”, Spedali Civili, Brescia, Italy
Trabeculectomy is the procedure of choice for the majority of patients with glaucoma requiring operative intervention. Anyway, it remains to a certain extent unpredictable with a significant rate of early postoperative complications related to postoperative ocular decompression that can lead to hypotony with its sight-threatening complication and late complications. For these reasons, there has been a continuous quest for a more predictable and physiologic glaucoma procedure with rapid recovery and a greater margin of safety and non-penetrating glaucoma procedures have emerged as an alternative to standard filtration surgery. The focus of this review is on surgical alternatives to trabeculectomy: non penetrating surgery such as deep sclerectomy and canaloplasty and the two novel surgical procedures Trabectome (Neo Medix Corp., Tustin, California, USA) and implantation of the Ex-PRESS Glaucoma Miniature Device (Optonol Inc., Kansas City, Kansas, USA).