Modified goniotomy for inflammatory glaucoma. Histologic evidence for the mechanism of pressure reduction.

A modified goniotomy (trabeculodialysis) was performed on both eyes of a 33-year-old woman who had glaucoma secondary to sarcoid uveitis. One month after trabeculodialysis, a cataract extraction was performed on one eye and a histologic specimen was obtained from the area of the filtration angle that was previously incised. Successful control of intraocular pressure has been maintained in both eyes for 18 months following trabeculodialysis. By light and electron microscopic examination, there was a nonhealed incision between the anterior chamber and Schlemm's canal. Trabeculodialysis, it is concluded, works by providing direct communication between the anterior chamber and Schlemm's canal, and might be effective in all trabecular obstructive glaucoma of short duration before secondary changes occur in the outer drainage channels.