By Ahmad A. Aref, Rohit Varma
This article presents professional guide at the strategies at present hired for the surgical procedure of glaucomatous sickness, overlaying either the host of novel microinvasive units for remedy of milder levels and the subtle options that increase luck premiums in sufferers with complex sickness. The severe steps in each one method are sincerely defined through many fine quality illustrations and surgical video clips. Pearls and pitfalls of a few of the thoughts are highlighted, and important info is equipped on symptoms, preoperative issues, capability intra- and postoperative problems, and methods for decreasing the prevalence of such antagonistic occasions. every one remedy process is addressed in a devoted stand-alone bankruptcy, making sure ease of reference for the practitioner. Readers will locate this booklet, written by means of the world over famous specialists within the box, to be an excellent resource of updated details on complex glaucoma surgical thoughts.
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However, the IOP findings were only significant at a few time points, and the increase in post-operative complications in the trabeculectomy group were due to the trabeculectomy part of the procedure . Currently, the long-term results of phacoemulsification alone versus phaco-trabeculectomy are not known. 4 The Timing of Lens Extraction Controversy surrounds the optimal timing of lens extraction in both acute and chronic PACG. Whilst some surgeons suggest primary lens extraction days after the resolution of the acute angle closure episode, surgery may be technically less challenging and safer once the corneal clarity and intraocular inflammation have settled after a few weeks.
In recent years, further evidence has emerged to incorporate goniosynechialysis (GSL) with cataract surgery . In this procedure, PAS are stripped manually under gonioscopic view. This can be performed either directly, using a blunt spatula, or via the application of viscoelastic (also known as viscogonioplasty, VGP), delicately avoiding potential complications such as bleeding, iridodialysis, and fibrinous uveitis. GSL is thought to be most effective in patients where PAS has been present for less than 6–12 months .
55. Jea S, Mosaed S, Vold S, Rhee D. Effect of a failed trabectome on subsequent trabeculectomy. J Glaucoma. 2012;21:71. 56. Töteberg-Harms M, Rhee DJ. Selective laser trabeculoplasty following failed combined phacoemulsification cataract extraction and ab interno trabeculectomy. Am J Ophthalmol. 2013;156:936–40. 57. Knape R, Smith M. Anterior chamber blood reflux during trabeculectomy in an eye with previous trabectome surgery. J Glaucoma. 2010;19:499–500. 58. Francis BA, Winarko J. Ab interno Schlemm’s canal surgery: trabectome and i-stent.