By Ahmad A. Aref, Rohit Varma
This article offers professional guideline at the concepts presently hired for the surgery of glaucomatous affliction, protecting either the host of novel microinvasive units for therapy of milder phases and the sophisticated recommendations that improve good fortune charges in sufferers with complex sickness. The severe steps in every one approach are truly defined through many top quality illustrations and surgical video clips. Pearls and pitfalls of some of the options are highlighted, and necessary info is supplied on symptoms, preoperative concerns, strength intra- and postoperative issues, and methods for lowering the prevalence of such adversarial occasions. each one therapy strategy is addressed in a devoted stand-alone bankruptcy, making sure ease of reference for the practitioner. Readers will locate this ebook, written through the world over famous specialists within the box, to be a superb resource of updated details on complicated glaucoma surgical thoughts.
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Ophthalmologica. 1997;211:126–39. 35. Loewen R, Lagouros E, Loewen NA. Trabectomemediated ab interno trabeculectomy in highly complex glaucomas. Paper presented at: Association for 3 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. Trabectome-Mediated Ab Interno Trabeculectomy for Secondary Glaucoma… Research in Vision and Ophthalmology Annual Congress, Orlando, 2014. Brown N, Jones L. Trabectome outcomes in uveitis patients. American Glaucoma Society Meeting; 2012. Arlene H, Rhee DH, Chen TC, et al.
There was no statistically significant difference in the complication rate between the two groups. A second, smaller study found that previous argon laser trabeculoplasty (ALT) may be a risk factor for failure . Previous selective laser trabeculoplasty (SLT) has also been analyzed separately as a risk factor for failure . In fact, in patients with PXG, a small retrospective comparative trial found that the group of patients who previously failed SLT (failure was defined as IOP > 16 mmHg) prior to combined phaco-trabectome actually had lower final IOP than patients with no history of SLT .
After trabectome and cataract surgery have concluded, the entire anterior chamber can be left filled with viscoelastic to facilitate tube shunt implantation and tube insertion. For the glaucoma drainage device implantation, an 8 mm long, limbus-parallel cut-down to the sclera is made either in the superotemporal or inferonasal position that is not more than 5 mm posterior to the limbus. The dissection is carried anterior to the limbus and posterior close to the recti muscles. The recti muscles and their insertions are visualized with muscle hooks.