To report a case of ab interno trabeculotomy with Trabectome® (NeoMedix Corp., CA, USA) conducted on a refractory primary open angle glaucoma (POAG) patient.

Trabectome® has microelectrocautery with simultaneous infusion and aspiration of debris and ablates a segment of trabecular meshwork and the inner wall of Schlemm's canal. The patient, a 54-year-old man had uncontrolled intraocular pressure (IOP) with topical anti-glaucoma medications after trabeculectomy and Ahmed valve implantation for POAG. For the patient, ab interno trabeculotomy with Trabectome® was performed. There were no other postoperative complications except for microhyphema immediately after surgery. The IOP was controlled between 14 to 24 mm Hg up to 3 months postoperatively with topical anti-glaucoma medications (Cosopt®, Alphagan-P®, Lumigan®).

Ab interno trabeculotomy with Trabectome® appears to offer a newer method of lowering IOP in POAG than conventional trabeculectomy and glaucoma drainage device surgery.