Stab incision glaucoma surgery (SIGS) a new technique for guarded filtration surgery with/without simultaneous phacoemulsification

Session Details

Session Title: Glaucoma II

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 09:02

Venue: Boulevard F (Level 1)

First Author: : S.Jacob INDIA

Co Author(s): :    A. Agarwal              

Abstract Details

Purpose:

To evaluate SIGS as a new guarded glaucoma filtration surgery

Setting:

Dr. Agarwal's Eye Hospital, Chennai, India

Methods:

A direct trans-conjunctival single step entry was created into the anterior chamber via a sclero-corneal tunnel using a 2.8 mm keratome. The SIGS tunnel was then intentionally compromised by punching the posterior corneal lip with a 1mm Kelly's Descemet's punch. Filtration was checked for and the single sub-conjunctival 2.8mm incision is closed. A PI was made only in cases of angle closure glaucoma, Peripheral Anterior Synechiae, shallow AC and intra-operative iris peaking into the ostium.

Results:

27 eyes of 24 patients underwent SIGS either in isolation or in combination with phacoemulsification. Mean follow up was for 26.4+/-7.8 weeks (Range 13 to 38 weeks). There was reduction in IOP in 96.2% of eyes with mean reduction of -18.3+/-12.4 mm Hg. Ostium was visible in all cases on ASOCT. There was no case of post-operative shallow AC. A biplanar tunnel provides a posteriorly directed flow and lack of a routine PI in all cases decreases post-operative AC reaction.

Conclusions:

A new technique of guarded glaucom asurgery - SIGS - is possible without conjunctival dissection. Complete elimination of sub-conjunctival dissection and bleb elevation by hydrostatic physiological expansion of sub-conjunctival drainage channels decreases the risk of failure from scarring. surgery is easier, faster and less traumatic

Financial Interest:

NONE