How are posterior sub-Tenon pockets dissected during trabeculectomy?

Updated: May 18, 2020
  • Author: Maria Hannah Pia Uyloan de Guzman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Conjunctival dissection

Some elderly individuals have developed spontaneous disinsertion of the Tenon capsule. If the Tenon capsule insertion cannot be found, do not aggressively manipulate the episclera in an attempt to find it.

When dissecting the posterior sub-Tenon pockets, orient the curvature of the scissors to match the curvature of the globe to make the dissection easier and smoother. When dissecting very far posteriorly keep in mind the location of the optic nerve and vortex veins.

Keep the conjunctiva moist throughout the procedure to keep the cut edges from rolling up and to reduce postoperative conjunctival inflammation.

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