Tanito Ab Interno Trabeculectomy Micro-hook
Designed by Dr. Masaki Tanito, M.D., PhD. (Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan).
Comments from Dr. Masaki Tanito, “These hooks are developed to perform trabeculotomy by ab interno approach under the observation of trabecular meshwork by using gonioprism. A straight type is suitable for temporal approach to the nasal meshwork or for superior approach to the inferior meshwork; angled–left and –right hooks are suitable for nasal approach to the temporal meshwork. The tip of the hook is enough sharp to enter directly into the Schlemm’s canal; trabecular meshwork is easily incised by moving the tip of the hook circumferentially. To avoid unintended damage to the outer wall of Schlemm’s canal, keeping the proper depth of the tip is critical. At the proper depth, metal reflex of the tip of the hook is visible through the meshwork tissue. Invisibility of the tip and any resistance during the incision indicate that the position of the hook is too deep; in such case, pull the tip to the meshwork surface to reappear the metal reflux through the meshwork and incise the meshwork at a depth with resistance free.