Trabeculectomy is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye's trabecular meshwork and adjacent structures.

An initial pocket is created under the conjunctiva and Tenon's capsule and the wound bed is treated for several seconds to minutes with mitomycin C (MMC, 0.5–0.2 mg/ml) or 5-fluorouracil (5-FU, 50 mg/ml) soaked sponges.

Alternatively, non-chemotherapeutic adjuvants can be implemented to prevent super scarring by wound modulation, such as the ologen collagen matrix implant.

[1][2][3][4][5] Some surgeons prefer "fornix-based" conjunctival incisions while others use "limbus-based" construction at the corneoscleral junction which may allow easier access in eyes with deep sulci.

(4) aqueous flow into cut ends of Schlemm's canal into collector channels and episcleral veins (5) into a cyclodialysis cleft between the ciliary body and the sclera if tissue is dissected posterior to the scleral spur.

The space created from the deep scleral dissection is proposed to accommodate certain biocompatible spacer or devices in order to prevent subscleral fibrosis and to maintain good filtering results in this modified operation.

[10] Examples of Trabeculectomy-modifying devices are Ex-PRESS, Gelfilm, XEN Gel stent, antifibrotic materials (e.g Ologen), ePTFE (expanded polytetrafluoroethylene) membrane and PreserFlo MicroShunt.

[10] In addition, the PreserFlo MicroShunt may help prevent complications such as postoperative hypotony or bleb leakage; however, this technique may have a lower effectiveness at reducing intraoculur pressure compared to a standard trabeculectomy procedures.

[11] Currently, there are no published trials which compare the efficacy and safety of ab interno trabeculectomy with Trabectome with other procedures for treating glaucoma.