Subscleral implantation of biodegradable polylactide drainage in refractory posttraumatic glaucoma treatment
Abstract
PURPOSE: A comparative analysis of long-term results of subcleral implantation of two models of “Glautex” biodegradable drainage device and Ahmed glaucoma valve in patients with refractory post-traumatic glaucoma (RPTG).
METHODS: The article presents an analysis of 2 methods of RPTG drainage surgery results. The author’s operation modification includes trabeculectomy, reverse cyclodialysis and the formation of a deep scleral flap, on which the drainage socket is put on. Patients are divided into 3 groups according to the type of surgical treatment: 1) subscleral implantation of Glautex drainage device in the form of a socket (17 patients); 2) implantation of a similar socket drainage device with a triangular tongue on the one side (10 patients); 3) Ahmed’s valve implantation (26 patients).
Average intraocular pressure (IOP) before the surgery was 33.9±5.47 mm Hg.
RESULTS: The hypotensive effect persisted for 3 months in all cases. Three months after Ahmed’s valve implantation IOP level in 7 patients increased to 34.1±4.65 mm Hg, due to conjunctival-scleral scarring in 4 cases and displacement of the drainage tube into the scleral fistula in 3 cases. One patient developed a conjunctival decubitus ulcer above the tube after 5 months. In other patients (18 eyes) IOP remained normal with the average level of 15.3±2.56 mm Hg. The only complication after Glautex drainage device implantation included a single case of fistula obliteration 1 month after the surgery. IOP level 1 year after surgery was 15.3±2.67 mm Hg in the first group and 14.2±1.78 mm Hg in the second group. Ultrasonic biomicroscopy revealed that slit-like spaces facilitating the drainage formed at the implant site and persisted throughout the follow-up period.
CONCLUSION: Glautex drainage device implantation in patients with RPTG is characterized by a stable hyportensive effect and an absence of severe complications observed after Ahmed glaucoma valve implantation.
About the Authors
A. V. Stepanov
Moscow Helmholtz’s Research Institute of Eye Diseases
Russian Federation
Russian Federation
Med.Sc.D., Professor, Main Research Associate of the Department of Traumatology and Reconstructive Surgery
14/19 Sadovaya-Chernogryazskaya st., Moscow, Russian Federation, 105062
U. Sh. Gamzayeva
Moscow Helmholtz’s Research Institute of Eye Diseases
Russian Federation
Russian Federation
M.D., Post-graduate of the Department of Traumatology and Reconstructive Surgery
14/19 Sadovaya-Chernogryazskaya st., Moscow, Russian Federation, 105062
N. R. Tedeyeva
Moscow Helmholtz’s Research Institute of Eye Diseases
Russian Federation
Russian Federation
Ph.D., M.D., Physician
14/19 Sadovaya-Chernogryazskaya st., Moscow, Russian Federation, 105062
K. V. Lugovkina
Moscow Helmholtz’s Research Institute of Eye Diseases
Russian Federation
Russian Federation
Ph.D., M.D., Research Associate of the Department of Ultrasound Research
14/19 Sadovaya-Chernogryazskaya st., Moscow, Russian Federation, 105062
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Review
For citations:
Stepanov A.V., Gamzayeva U.Sh., Tedeyeva N.R., Lugovkina K.V. Subscleral implantation of biodegradable polylactide drainage in refractory posttraumatic glaucoma treatment. National Journal glaucoma. 2018;17(2):39-46. (In Russ.)
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