SURGERY OF GLAUCOMA PREVENTION AND MANAGEMENT OF COMPLICATIONS

被引：1

作者：

Joaquin Barraquer

separated and facilitate the formation of a filtering bleb

which is usually diffuse and not very prominentIn the prevention and management of postoperative complications

especially ciliary block or malignant glaucoma

Healon has been found to be extremely useful Careful suturing of the scleral pening

reformation of the anterior chamber with Healon and instillation of atropine to produce adequate relaxation of the ciliary body ^{[1
]}

and the administration of local and general corticosteroids to inhibit the inflammatory reaction are imperative to avoid these complications If

in spite of all precautions

ciliary block glaucoma does occur

osmotherapy must be started immediately intravenous mannitol

preferably

lyophilized urea

the pupil must be dilated using atropine and phenylephrine ^{[4
,10
]}

and the doses of corticosteroids should be increased mg of prednisone in intramuscular injection and frequent instillation of dexamethasone eye drops If the problem does not resolve within a few hours ^{[60
]}

immediate reintervention is imperative Posterior sclerotomy at the level of the pars plana ciliaris Vitrectomy and aspiration of the aqueous humor which is retained behind andor in the vitreous humor Reformation of the anterior chamber with Healon The pupil should be maintained dilated with atropine during a prolonged period of time Prof Joaquin Barraquer MD ^{[1
,2
,3
,4
,4
]}

FACS Instituto Barraquer Barcelona

Spain

机构：

[1] Barcelona(Spain)

来源：

眼科学报 | 1986年 / 03期

关键词：

SURGERY OF GLAUCOMA PREVENTION AND MANAGEMENT OF COMPLICATIONS; very;

D O I：

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摘要：

<正> In cases of angle-closure glaucoma YAG-Laser iridotomy or classical peripheral iridectomy should be performed early. If the trabeculum is already irreversibly damaged, trabeculectomy must be performed. In open-angle glaucoma cannot be controlled with medical therapy nor Laser-trabeculoplasty, surgical treatment is imperative. Generally, trabeculectomy is considered the operation of choice.Collapse of the anterior chamber is less frequent with trabeculectomy as compared to the classical filtering operations, but it still does occur occasionally. To prevent this complication, the author recommends injection of Healon (sodium hyaluronate) immediately after opening the anterior chamber.If in spite of all precautions the anterior chamber is lost in the postoperative course (due to ciliary block glaucoma or to excessive filtration with secondary detachment of the choroid and ciliary body) and medical treatment is ineffective, reintervention becomes necessary. Injection of Healon to reform the anterior chamber is of choice.

引用

页码：161 / 162

页数：2