**6. Reducing the width of the filtration track**

The standard 100 micron glaucoma tip has a teflon sleeve of 50 microns thickness.For it to pass through the limbus, the plasma on the tip has to be wider than combined width of the fibre and sleeve. At medium power, the plasma cloud is 50 microns, therefore the track width is 200 microns. At high power setting the plasma cloud is 75 microns on all sides of the filament, therefore the track size is 250 microns. If we use naked filaments of 75, 100 or 120 microns at low energy, we can have smaller widths of MTF tracks. Thinner tracks cause slow decompression during surgery. Since the speed of aqueous out flow gets reduced, the track is less likely to attract the iris.If a block occurs, the iris tissue is small and is easy to dislodge. Some successful cases show no bleb at all.

The steps of mini-MTF operation are as follows:


**Figure 20.** The bleb after Mini-MTF. The anterior chamber has remained well formed.The bleb appearance is reassur‐

Minimally Invasive Glaucoma Surgery – Strategies for Success

http://dx.doi.org/10.5772/54421

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MMC reduces scar formation. This helps to improve results. Unlike other surgical techni‐ ques in which MMC is applied under the conjunctiva with sponges, we raise a bleb with 0.1 to 0.2 ml of a desired concentration of MMC. This assures a wider spread that results in a borderless bleb.Our OCT observations of the blebs show that MTF cases maintain a healthy cover of the conjunctiva. There is no danger of bleb leakage, because no conjunctival flap is made. MMC concentration has been used varying from 0.005 % to 0.04 %. The higher risk

ing. L are for lymphatics.

**7. Mitomycin**

Here is a film on small track MTF

http://www.youtube.com/watch?v=WEn\_AS\_h9Do

**Figure 19.** A naked 75 micron Fugo blade tip kept close to the conjunctiva retracting sapphire blunt blade, passes through the conjunctiva and limbus as soon as it is activated.The bleb forms slowly. Air is injected in the anterior chamber at the end.

**Figure 20.** The bleb after Mini-MTF. The anterior chamber has remained well formed.The bleb appearance is reassur‐ ing. L are for lymphatics.

Here is a film on small track MTF

http://www.youtube.com/watch?v=WEn\_AS\_h9Do
