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Surgical treatment of refractory glaucoma: indications, complications, outcomes

Poster Details

First Author: S.Nikolashin RUSSIA

Co Author(s):                  

Abstract Details



Purpose:

To conduct a comparative analysis of refractory glaucoma surgical treatment using different methods of anterior chamber drainage.

Setting:

The Academician S.N. Fyodorov FSBI IRTC 'Eye Microsurgery' Tambov branch, Tambov, Russia.

Methods:

All patients with refractory glaucoma were divided into three groups. In group I there was performed a retrospective examination of 34 glaucomatous eyes, which underwent deep sclerectomy, group II included 53 patients with Ahmed valve implants and group III consisted of 13 patients implanted with Ex-press shunt. The preoperative visual acuity in group I was 0.3±0.05, in group II - 0.04±0.01, in group III - 0.25±0.04. The preoperative intraocular pressure (IOP) in group I was 31.0±2.0 mm Hg, in group II - 36.0±2.8 mm Hg, in group III - 32.0±2.1 mm Hg.

Results:

Group I. In the postoperative period the IOP was compensated (17.6±0.72 mm Hg) in all patients. Visual acuity was 0.25±0.04. The postoperative complications in group I accounted for 29.4%. Group II. The pain syndrome in the postoperative period was jugulated in 100% cases. Visual acuity was 0.02±0.01. The IOP was normalized in all patients (18.4±0.83 mm Hg). The postoperative complications in group II accounted for 32.2 %. Group III. The IOP in all patients was compensated (18.9±0.87 mm Hg). Postoperative visual acuity was 0.3±0.06. In group III the postoperative complications accounted for 47%.

Conclusions:

1. The comparative results of deep sclerectomy, shunt implantation and Ahmed valve implantation showed not significant difference between the surgical intervention outcomes. 2. The choice for surgical intervention technique depended on the initial status of the eye, the value of the anterior chamber angle and its depth, the presence of the iris and the anterior chamber angle rubeosis. 3. The drainage systems application gave the opportunity to compensate high IOP more effectively and safely. FINANCIAL INTEREST: NONE

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