Περιγραφή
Glaucoma is a condition of the eye in which the optic nerve is damaged due to increased fluid pressure in the eye. Left untreated, the condition may lead to permanent blindness.
This comprehensive guide discusses various surgical techniques used to treat glaucoma, covering both new and traditional procedures. Non-penetrating surgical methods are also examined and the advantages and disadvantages of different surgeries are highlighted.
Written by a recognised Portuguese author group, this manual includes a DVD of 17 videos demonstrating surgical procedures.
Key points
- Comprehensive guide discussing new and traditional surgical techniques for the treatment of glaucoma
- Examines non-penetrating surgical procedures
- Compares advantages and disadvantages of different techniques
- Recognised Portuguese author group
- Includes DVD of 17 videos demonstrating surgical procedures
Περιεχόμενα
1. Trabeculectomy 1
Pedro Faria
• Indications and Contraindications 1
• Preoperative Assessment 2
• Surgical Technique 2
– Anesthesia 2
– Opening of the Conjunctiva 2
– Scleral Flap 2
– Paracentesis 2
– Sclerectomy 3
– Iridectomy 3
– Conjunctival Closure 3
• Methods to Prevent Scarring of the Filtration Bleb 3
– Antimetabolites 3
– Bleb-forming Implants 4
– Anti-VEGFs 4
• Intraoperative Complications 4
– Hyphema 4
– Athalamia 4
– Vitreous Loss 4
– Expulsive Hemorrhage 5
• Immediate Postoperative Complications 5
– Hypothalamia with Ocular Hypotony 5
– Hyphema 5
– Choroidal Detachment 5
– Hypotonic Maculopathy 5
– Hypothalamia with Ocular Hypertony 5
– Suprachoroidal Hemorrhage 6
– Intraocular Infection 6
– Ocular Hypertension 6
– Encapsulated Bleb 6
• Late Postoperative Complications 6
– Late Hypotony 6
– Cataracts 7
2. ExPressTM—Mini Glaucoma Shunt 8
Arabela Futre Coelho
• Indications 8
• Contraindications 9
• Surgery 9
– Anesthesia 9
– Surgical Technique 9
• Postoperative Therapy 10
• Complications 12
– Intraoperative 12
– Postoperative 12
3. Posterior Drainage Devices 14
Manuela Carvalho
• Device Characteristics 14
– Presence or Absence of a Flow Restriction Mechanism
(Restrictive Versus Nonrestrictive) 14
– Plate Surface Area 15
– Composition 16
• Classic Indications 16
– Eyes in which Trabeculectomy with Mitomycin C (MMC), even with Adjunctive
Antimetabolite Use, Have a High-Risk of Failure 16
– Eyes in which Trabeculectomy is Technically Not Possible or Has a High-Risk of
Intraoperative Complications 16
– Patients in whom Trabeculectomy with MMC Has a very High-Risk of Postoperative
Complications 16
• Recent Indications 16
– Relative Contraindications 17
• Preoperative Assessment 17
• General Assessment 17
• Types of Anesthesia 17
• Surgical Technique 17
– Globe Fixation 17
– Conjunctival Flap 17
– Plate Insertion and Fixation 18
– Paracentesis 18
– Tube Insertion 18
– Tube Covering 18
– Conjunctival Suture 19
• Technique Variants 19
– Tube Insertion in the Posterior Chamber 19
– Tube Insertion in the Pars Plana 19
– Technique Variations to Avoid Early Postoperative Hypotony (Nonvalved Implants) 19
– Use of Antiscarring Agents 20
Postoperative Complications 20
– Early Hypotony 20
– Transient Hypertensive Phase 20
– Tube- or Plate-related Complications 20
– Other Complications of Glaucoma Surgery 21
4. Deep Sclerectomy 23
Maria da Luz Freitas
• Indications 24
– Strictu Sensu 24
– Relative Contraindications 25
– Absolute Contraindications 25
• Patients Assessment 25
• Surgical Technique 25
• Difficulties/Complications and their Intraoperative Resolution 30
– Depth of Deep Scleral Flap 30
– Perforation of Trabeculodescemetic Window 30
• Immediate Postoperative Complications and Resolution of Complications (1–10 Days) 30
– Seidel 30
– Inflammation 30
– Hypotony 31
– High Intraocular Pressure 31
– Choroidal Detachment 31
– Low Anterior Chamber 31
– Hematic Tyndall/Hyphema 31
– Descemets Membrane Detachment 31
– Reduced Visual Acuity 31
• Late Postoperative Complications and Resolution of Complications (2–5 Weeks) 31
– Increased Intraocular Pressure 31
– Blebitis 31
5. Gonioscopic Surgery: Trabecular Micro-Bypass Stent Implantation 33
A Rodrigues Figueiredo
6. Canaloplasty 37
Maria da Luz Freitas
• Indications 37
• Relative Contraindications 37
• Absolute Contraindications 37
• Patients Assessment 38
• Surgical Technique 38
– Preoperative Preparation 38
– Surgery Location 38xxii
– Scleral Flaps, Opening of Schlemms Canal Opening and Creation of a
Trabeculodescemetic Window 40
– Catheterization, Dilation and Distention of Schlemms Canal 41
– Closure of Scleral Flap and Conjunctiva 41
– Difficulties/Complications and their Intraoperative Resolution 44
– Immediate Postoperative Complications and Resolution of Complications (1–10 Days) 45
– Late Postoperative Complications and Resolution of Complications (2–5 Weeks) 46
7. Combined Surgery 48
Teresa Gomes
• Indications and Contraindications 48
• Patients Clinical Evaluation 49
• Surgical Technique amd Complications 50
8. Lens Surgery in Glaucoma 55
Maria Reina
• Indications and Contraindications 55
• Clinical Evaluation or Patient Evaluation 57
• Description of Surgical Technique, Difficulties and their Resolution 59
• Immediate Postoperative Complications and Resolution of Complications 62
Index 65
