Surgery of viscocycloidioretraction with excision of episclera in the treatment of patients with neovascular glaucoma

Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : N.Olga UKRAINE

Co Author(s): :                           

Abstract Details

Purpose:

The aim of the work was to increase the effectiveness of organ-preserving surgical treatment of patients with neovascular glaucoma (NVG).

Setting:

The impact on the processes of excessive proliferation in the organ-preserving surgical treatment of patients with NVG remains an urgent problem of ophthalmic surgery. With the development of visco-surgery, it became possible to use viscoelastics as drainage materials.

Methods:

We investigated the immediate and long-term results of surgical treatment using the operation of viscocyclo-idioretratraction with excision of episclera (VCIRE) in 38 patients (40 eyes) with decompensated NVG (group 1). There were 22 patients (24 eyes) with diabetes mellitus and 16 patients (16 eyes) after occlusions of the retinal vessels. The age of patients from 19 to 79 years. The second group (control) consisted of 22 patients (22 eyes) operated on using fistulatory operations. The examination included visometry, biomicroscopy, ophthalmoscopy, gonioscopy, perimetry, tonometry, ultrasound of the eye. The intraocular pressure (IOP) before the operation was 39.4 ± 1.5 mm Hg.

Results:

After VCIRE patients had a moderate increase in IOP and antihypertensive therapy for 2-3 days. In group 1 after 7 days IOP was 19.2 ± 1.3 and in group 2 - 16.8 ± 1.7 mm Hg.  12 months after VCIRE in 86.8% (33 patients) IOP was <22 mm Hg : in 29 patients (76.3%) without antihypertensive therapy (WAT), and in 4 patients with original combination of dorzolamide and timolol. In group 2 after 12 months IOP <22 mm Hg was determined WAT in 81.8% (18 patients). In 2 patients, enucleation was performed in connection with pain syndrome and high IOP.

Conclusions:

Clinical data confirm the pronounced long-term hypotensive effect of the operation of VCIRE. Excision of the episclera site reduced the proliferation of connective tissue in the surgical zone, the introduction of viscoelastic into the suprachoroidal space formed its dilatation, contributed to the formation of functional cavities between the sclera and conjunctiva, which is confirmed by the results of morphological research. A decrease in IOP below 22 mm Hg for 12 months WAT after the operation VCIRE was observed in 76.3% of cases.

Financial Disclosure:

None