Authors
Uyanaeva A.A., Starostina A.V., Sidorova A.V., Burlakov K.S.
The S. Fyodorov Eye Microsurgery Federal State Institution, Beskudnikovsky Boulevard, Moscow
Abstract
Rationale: Secondary glaucoma in patients after keratoplasty is refractory to many treatment methods, and is also often accompanied by severe comorbid pathology of the eyeball. The choice of a surgical treatment method for such patients causes difficulties for the ophthalmic surgeon, which determines the relevance of this problem.
Objective: To evaluate the effect of surgical treatment of secondary glaucoma in patients after keratoplasty against the background of comorbid pathology (aphakia, aniridia, vitreous hernia, avitria, etc.).
Methods: At the S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, patients with secondary refractory glaucoma after keratoplasty against the background of concomitant pathology were examined and the following was performed: Ahmed valve drainage was implanted in three patients and laser transscleral cyclocoagulation was performed in one patient.
Results: In the postoperative period, after implantation of the Ahmed valve drainage and laser transscleral cyclocoagulation, intraocular pressure was normalized. In patients with Ahmed valve implantation, the drainage tube in the anterior chamber is in the correct position. Up to 12 months after surgery there are no complaints, intraocular pressure is compensated.
Conclusion: The choice of treatment tactics for secondary glaucoma in patients with comorbid pathology after keratoplasty is always individual and is determined by the severity of changes in the structures of the anterior chamber angle, as well as concomitant pathology (aphakia, aniridia, vitreous hernia, avitria, etc.) With pronounced structural changes in the anterior segment of the eye The operations of choice are most often laser transscleral cyclophotocoagulation and implantation of Ahmed valve drainage. The most predicted reduction in intraocular pressure in the early stages after surgery is provided by implantation of the Ahmed valve. Laser transscleral cyclocoagulation is possible both as the first stage and after implantation of the Ahmed valve.
Keywords: secondary glaucoma, Ahmed drainage, intraocular pressure, laser transscleral cyclocoagulation, keratoplasty.
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