Atwal Balanced Approach - Posterior Chamber Glaucoma Filter

The footage presents the ABA procedure, which combines a mini trabeculectomy (filtration from the anterior chamber) with TCF (filtration from the posterior chamber). In comparison to the standard blunt trabeculectomy, this portion of ABA is much quicker, safer and controlled. After the plasma trabeculectomy, a posterior chamber TCF is created in order to drain fluid from the posterior chamber of the eye. During the ABA procedure aqueous fluid can be drained in a balanced manner from both behind and front of the iris. TCF provides the larger bore thus insures that the pressure behind the iris is always lower than that in the anterior chamber. Therefore, independently of the intraocular pressure, the force vector behind the iris is always too low to push the iris forward. Hence the complete absence of post operation flat anterior chambers. Moreover the trab flap doesn’t need to be sutured down and a water tight conjunctival closure created. 2 or 3 conjunctival sutures are enough. ABA filtration seems to be well-suited to be combined with standard phacoemulsification cataract surgery.