ArticleOphthalmology. Glaucoma
Greater Outflow Facility Increase After Targeted Trabecular Bypass in Angiographically Determined Low-low Regions.
Article in Ophthalmology. Glaucoma. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Aqueous Humour Outflow Assessment Using Imaging-Based Techniques in Angle-Based Minimally Invasive Glaucoma Surgery (MIGS): A Systematic Review.Clinical & experimental ophthalmology · 2026Pooled it
- Aqueous Angiography-Guided Bent Ab Interno Needle Goniectomy in High Versus Low Aqueous Humor Outflow Regions in Primary Open Angle Glaucoma: A Pilot Randomized Controlled Trial.Journal of glaucoma · 2025Trial
- Segmental flow responses in glaucomatous trabecular meshwork cells.Biomaterials advances · 2026Article
- Aqueous humour outflow improvement after excimer laser trabeculostomy.The British journal of ophthalmology · 2026Article
- Transcriptomic Profiling of High vs. Low Flow Regions of Mouse and Human Trabecular Meshwork.bioRxiv : the preprint server for biology · 2026Article
- Machine-Learning-Based Automated Schlemm's Canal Volumetric Segmentation for Optical Coherence Tomography.Chemical & biomedical imaging · 2026Article
- Cholinergic Improvement of Low-Flow Segmental Aqueous Humor Outflow in Humans.Ophthalmology science · 2026Article
- Assessing Effects of Riboflavin/UV-A Cross-Linking on Aqueous Outflow Facility, Corneal Biomechanics and Their Association With Intraocular Pressure.Journal of biophotonics · 2026Article
- Early success and safety of three minimally invasive glaucoma surgery techniques combined with cataract surgery in glaucoma patients.International ophthalmology · 2025Observational
- Robotic Optical Coherence Tomography With Expanded Three-Dimensional Field-of-View Using Point-Cloud-Based Volumetric Montaging.IEEE transactions on medical imaging · 2025Article
- Segmental Uveoscleral Outflow and its Relationship With Trabecular Outflow in Monkey Eyes.Investigative ophthalmology & visual science · 2025Article
- Robotic Visible-Light Optical Coherence Tomography Visualizes Segmental Schlemm's Canal Anatomy and Segmental Pilocarpine Response.Investigative ophthalmology & visual science · 2025Article
- Total outflow facility before and after goniotomy inFrontiers in medicine · 2025Article
- Robotic Visible-Light Optical Coherence Tomography Visualizes Segmental Schlemm's Canal Anatomy and Segmental Pilocarpine Response.bioRxiv : the preprint server for biology · 2024Article
- Reduced Aqueous Humor Outflow Pathway Arborization in Childhood Glaucoma Eyes.Translational vision science & technology · 2024Article
- Comparison of Superior versus Inferior Canaloplasty and Trabeculotomy Using the OMNI Surgical System.Clinical ophthalmology (Auckland, N.Z.) · 2024Article
- Segmental Unconventional Outflow in Mouse Eyes.Investigative ophthalmology & visual science · 2023Article
- Enhanced Aqueous Humor Outflow Following Trabeculotomy in Primary Congenital Glaucoma Eyes.Ophthalmology. GlaucomaArticle
- Minimally Invasive Glaucoma Surgery and the Distal Aqueous Outflow System: The Final Frontier?Ophthalmology. GlaucomaArticle
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
purposeTo investigate the impact of trabecular bypass surgery targeted to angiographically determined high- vs. low-aqueous humor outflow areas on outflow facility (C) and intraocular pressure (IOP).
designEx vivo comparative study. SUBJECTS: Postmortem ex vivo porcine and human eyes.
methodsPorcine (n = 14) and human (n = 13) whole globes were acquired. In both species, anterior segments were dissected, mounted onto a perfusion chamber, and perfused using Dulbecco's phosphate buffered solution containing glucose in a constant flow paradigm to achieve a stable baseline. Fluorescein was perfused into the anterior chamber and used to identify baseline segmental high- and low-flow regions of the conventional outflow pathways. The anterior segments were divided into 2 groups, and a 5 mm needle goniotomy was performed in either a high- or low-flow area. Subsequently, C and IOP were quantitatively reassessed and compared between surgery in baseline "high-flow" and "low-flow" region eyes followed by indocyanine green angiography.
main outcome measuresOutflow facility.
resultsIn all eyes, high- and low-flow segments could be identified. Performing a 5-mm goniotomy increased outflow facility to a variable extent depending on baseline flow status. In the porcine high-flow group, C increased from 0.31 ± 0.09 to 0.39 ± 0.09 μL/mmHg/min (P = 0.12). In the porcine low-flow group, C increased from 0.29 ± 0.03 to 0.56 ± 0.10 μL/mmHg/min (P < 0.001). In the human high-flow group, C increased from 0.38 ± 0.20 to 0.41 ± 0.20 μL/mmHg/min (P = 0.02). In the human low-flow group, C increased from 0.25 ± 0.11 to 0.32 ± 0.11 μL/mmHg/min (<0.001). There was statistically significant greater increase in C for eyes where surgery was targeted to baseline low-flow regions in both porcine (0.07 ± 0.09 vs. 0.27 ± 0.13, P = 0.007 μL/mmHg/min, high vs low flow) and human eyes (0.03 ± 0.03 vs. 0.07 ± 0.02, P = 0.03 μL/mmHg/min, high vs. low flow).
conclusionsTargeting surgery to low-flow areas of the trabecular meshwork yields higher overall facility increase and IOP reduction compared to surgery in high-flow areas. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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