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Patient selection for new minimally invasive glaucoma surgical procedure

Poster Details


First Author: C.Găvănescu ROMANIA

Co Author(s): A. Burloiu   L. Petrescu   R. Ionescu   P. Grecu   A. Roman        

Abstract Details

Purpose:

Our paper evaluates the safety and the effectiveness of a new minimally invasive glaucoma surgery procedure: ab interno trabeculectomy using a 25 gauge or 23 gauge vitreous cutters and a gonioscopic visualization system (AITV). For the last 2 years we’ve included 40 suitable patients for AITV and we established the inclusion and the exclusion criteria for it.

Setting:

In the beginnings we’ve considered a limited patient selection and only after obtaining good results, we’ve extended the inclusion criteria. This study synthesizes who could benefit from AITV, by knowing which are the advantages and the limitations of this procedure.

Methods:

Until now, AITV indications are: open angle glaucoma, uncontrolled intraocular pressure (IOP), higher than 21 mmHg on maximally or tolerably medical treatment, phakic or pseudophakic patients with a clear view of the angle, less than 0.7 cupping, acute angle closure and chronic angle closure (the last two indications are always associated with lens extraction and sometimes associated with vitrectomy). The exclusion criteria for AITV are: neovascular glaucoma, cornea illness causing a poor view of the angle, active inflammation or infection (including uveitic glaucoma), more than 0.7 cupping, vitreous in the anterior chamber, intraocular silicone oil and impaired episcleral venous drainage. The presence of conjunctival scarring is not a contraindication for AITV due to its cornea incision approach.

Results:

This surgical procedure substantially lowered the IOP of our 40 patients during a 24 months follow-up period. The mean pre-operative IOP was 28 mmHg and the mean post-operative IOP was 16 mmHg which maintained during the whole follow-up period.

Conclusions:

AITV is a promising procedure in lowering the IOP during 24 month follow-up period. Still, a new concept of an improved device with cutting and aspiration functions and better fitting in the anterior chamber angle in order to excise the trabecular meshwork would be more effective once created.

Financial Disclosure:

None

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