Glaucoma surgery

A survey of members of the American Glaucoma Society determined that viscoelastics are used for anterior chamber reformation at the slit-lamp in the postoperative clinical management. Some 47 % used viscoelastic substances in cases of iris-cornea touch, 88% in cases of lens-cornea touch (Salvo et al, 1999). 

Charteris and co-workers (1991) observed the formation of thin-walled filtration blebs with more microcysts than in the controls following subconjunctival and subscleral application of 1 % sodium hyaluronate. 

Barak and co-workers (1992) pointed out a lower degree of endothelial cell loss after trabeculectomy and an increasing number of postop lOP peaks with sodium hyaluronate use. 

Concomitant preparation of the Descemet s membrane (central to the Schwalbe s line) combined with a deep sclerectomy (actually a deep sclerocornectomy) leads to the formation of a small aqueous pool in the scleral sheath which empties 

Stegmann employs Healon GV to tamponade the canal of Schlemm and the deep sclerectomy space. Lately, hyaluronic acid implants (SKGEL 35, Corneal, Paris, France) or pork collagen (CGDD 10 , STAAR Surgical, Monrovia, Ca., USA) with longer persistence have been produced. 

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CAT-152 scFv TGFp2/Glaucoma surgery, proliferative vitreo retinopathy http //www.catplc.co.uk... 

Long-term use of topical antiglaucoma medications can induce local metaplastic changes in the conjimctiva. These are related to the active medications themselves, to their preservatives, or to the duration of topical treatment. Conjunctival shrinkage with foreshortening of the inferior conjunctival fornix is a possible consequence. Subsequent glaucoma surgery may be less successful. 

Coleman AL, Yu E, Evans SJ. Use of gonioscopy in Medicare beneficiaries before glaucoma surgery. J Glaucoma 2006 15 486-493. 

Cordeiro MF, Siriwardena D, Chang L, Khaw PT. Wound healing modulation after glaucoma surgery. Curr Opin Ophthalmol 2000 1 121-126. 

Donohue EK, CiofS GA. Glaucoma surgery Are there new perspectives in perioperative pharmacology Curr Opin Ophthalmol 1999 10 93-98. 

Proparacaine, a local anesthetic (ophthalmic solution 0.5%), is used in anesthesia for tonometry, anesthesia for the removal of foreign bodies or sutures from the eye, and anesthesia for cataract extraction and glaucoma surgery. 

It is a potent surface anaesthetic mainly used in ophthalmology and induces no initial irritation. Beeause of its rapid onset of aetion it is useful for most occular procedures that require topical anaesthesia such as tonometry, removal of foreign particles, gonioscopy and various short operative procedures which may involve the conjunctiva and cornea. It has also been reported to be employed frequently as a surface anaesthesia in glaucoma surgery and in cataract operations. 

Gomes dos Santos, A.L. Bochot, A. Doyle, A. Tsapis, N. Siepmann, J. Siepmann, R Schmaler, J. Besnard, M. Behar-Cohen, R Fattal, E. Sustained release of nanosized complexes of polyethyleni-mine and anti-TGF-beta 2 oligonucleotide improves the outcome of glaucoma surgery. J. Contr. Release 2006,112 (3), 369-381. 

Sodium hyaluronate is applied in the treatment of postoperative ocular hypo-tony in glaucoma surgery. Ocular hypotony caused by overfiltration (Fig. 104) is not only relevant in the development of visual acuity (Schwenn et al., 1996) but also subject to numerous complications. Sodium hyaluronate is particularly well suited for treatment of shallowed anterior chambers (Fig. 105) with threatening lentocorneal contact. 

Fig.l 04. Exuberant bleb formation with excessive outflow after filtering glaucoma surgery... 

Draeger J, Winter R, Wirth H. Viscoelastic glaucoma surgery. Trans Ophthalmol Soc UK 1983 103 270-273... 

Khaw, P. T, Midgal, C. Current techniques in wound healing modulation in glaucoma surgery. Current Opinion in Ophthalmology. 1996, v. 7. Iss. 2,24-33. 

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