By Ahmad A. Aref, Rohit Varma
This article presents professional guide at the options at present hired for the surgical operation of glaucomatous sickness, protecting either the host of novel microinvasive units for therapy of milder levels and the subtle ideas that increase luck premiums in sufferers with complex ailment. The serious steps in every one strategy are truly defined via many top quality illustrations and surgical movies. Pearls and pitfalls of some of the ideas are highlighted, and useful details is supplied on symptoms, preoperative concerns, capability intra- and postoperative issues, and methods for lowering the occurrence of such opposed occasions. each one therapy procedure is addressed in a committed stand-alone bankruptcy, making sure ease of reference for the practitioner. Readers will locate this ebook, written through across the world well-known specialists within the box, to be an outstanding resource of up to date details on complicated glaucoma surgical options.
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Extra info for Advanced Glaucoma Surgery
Tomlinson A, Leighton DA. Ocular dimensions in the heredity of angle closure glaucoma. Br J Ophthalmol. 1973;57:475–86. 6. Nongpiur ME, He MG, Amerasinghe N, et al. Lens vault, thickness and position in chinese subjects with angle closure. Ophthalmology. 2011;118:474–9. 7. Matsumura M, Mizoguchi T, Kuroda S, et al. Intraocular pressure decrease after phacoemulsificationaspiration + intraocular lens implantation in primary open angle glaucoma eyes. Nihon Ganka Gakkai Zasshi. 1996;100(11):885–9. 8.
Consequently, deepening of the anterior chamber achieved by lens extraction may improve aqueous access to the angle, and therefore reduce the IOP  (Figs. 3a, b). Weak evidence exists as to whether patients without glaucoma receiving cataract surgery achieve any reduction in IOP. 5 mm reduction at 3 years . IOP reductions of between 2–6 mmHg have been described following lens extraction in PACG eyes [8–11], notably greater in PACG compared to POAG eyes . A recent randomized, controlled trial evaluated laser peripheral iridotomy (LPI) versus lens extraction in patients with acute primary angle closure (APAC), following emergency medical management to lower the IOP.
With APAC, inflammation may lead to zonular weakness and lens instability . This may have secondary effects upon fluidic management and anterior chamber stability. In PACG, the lens itself may be bulky and cataractous, increasing the risk of sudden drop in IOP upon removal, and subsequent risk of suprachoroidal haemorrhage. Furthermore, the presence of a shallow anterior chamber may exacerbate endothelial damage, retard visual recovery, and occasionally lead to corneal decompensation. Additional risks in these PACG eyes include malignant glaucoma and post-operative IOP elevation, as well as prolonged post-operative inflammation .
Advanced Glaucoma Surgery by Ahmad A. Aref, Rohit Varma