Laser reconstruction of the non-penetrating deep sclerectomy zone blocked by peripheral iris
Abstract
PURPOSE: To study the effectiveness of laser reconstruction of the non-penetrating deep sclerectomy (NPDS) zone blocked by peripheral iris. METHODS: The study was based on the analysis of 95 cases (95 patients) of postoperative trabeculo-Descemet’s membrane (TDM) blockade with a part of peripheral iris: in 65 patients (65 eyes) — after NPDS in 30 patients (30 eyes) — after laser descemeto-goniopuncture (DGP). IOP level at the time of NPDS zone blockade diagnosis averaged 27.04±5.20 mmHg. All patients underwent laser reconstruction of the surgical zone, which included laser gonioplasty, iridectomy and, if possible, DGP. RESULTS: In 10 out of 65 cases of NPDS zone blockade, a suspension of formed elements was found in the anterior chamber fluid, in 3 of these cases patients presented with a 2 mm hyphema. In 27 cases (41.5%) NPDS zone blockade was not completely eliminated. On the 1st day after laser surgery, IOP decreased to an average of 17.34±3.50 mmHg. A 3 mm hyphema was observed in 2 cases of post-DGP blockade. Patients of the 2nd group had an average IOP level of 18.65±4.65 mmHg. It was possible to remove the operation zone blockade in 21 cases (70%), with 19 cases of partial and 2 cases of complete blockade. In other cases the blockade remained in more than 2/3 of the TDM length. CONCLUSION: One of the main predisposing factors of NPDS zone blockade onset is TDM perforation intraoperatively or during laser DGP.
About the Authors
N. S. Khodjaev
The S. Fedorov Eye Microsurgery State Institution
Russian Federation
M.D., Ph.D., Professor, Deputy Director
Russian Federation
M.D., Ph.D., Professor, Deputy Director
A. V. Sidorova
The S. Fedorov Eye Microsurgery State Institution
Russian Federation
M.D., Ophthalmic surgeon, Head of glaucoma surgery department
Russian Federation
M.D., Ophthalmic surgeon, Head of glaucoma surgery department
A. V. Starostina
The S. Fedorov Eye Microsurgery State Institution
Russian Federation
postgraduate student
Russian Federation
postgraduate student
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Review
For citations:
Khodjaev N.S., Sidorova A.V., Starostina A.V. Laser reconstruction of the non-penetrating deep sclerectomy zone blocked by peripheral iris. National Journal glaucoma. 2017;16(3):28-34. (In Russ.)
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