Efficiency of fistulizing surgery of secondary refractory glaucoma

• Main Authors: M. M. Bikbov, A. E. Babushkin, O. I. Orenburkina, E. N. Matyukhina
• Format: Article
• Language: Russian
• Published: Real Time Ltd 2018-10-01
• Series: Российский офтальмологический журнал
• Subjects: вторичная рефрактерная глаукома; фистулизирующие операции; трабекулэктомия; иридоциклоретракция; гипотензивный эффект; secondary refractory glaucoma; fistulizing operations; trabeculectomy; iridocycloretraction; antihypertensive effect
• Online Access: https://roj.igb.ru/jour/article/view/36

Purpose. To compare the results of traditional and modified fistulizing surgery for secondary refractory glaucoma. Material and methods. 39 patients (39 eyes) aged 25 to 79 (24 and 15 women) who received the surgery were divided into 2 groups: 17 patients of the control group underwent traditional trabeculectomy or deep sclerectomy while 22 patients of the main group received tunnel trabeculectomy with iridocycloretraction. 27 patients were followed up for up to 2 years. Results. No significant difference between the compared groups was found with regard to the incidence of early postoperative complications (hyphema, ciliochoroidal detachment). After surgery, which in some cases was supplemented by the course of additional antihypertensive therapy, IOP returned to normal in 77.8% of cases. For neovascular glaucoma, the results were worse both after modified and traditional trabeculectomy procedures (40.0%). The best sustained hypotensive and functional effect was achieved after tunnel trabeculectomy with iridocycloretraction (in 68.8% of cases), while after traditional trabeculectomy the effect was lower (45.5%). Conclusions. The obtained results show that the proposed modified operation may be considered, in some cases, as an alternative to drainage surgery in patients with refractory secondary glaucoma. Neovascular glaucoma is a contraindication to tunnel trabeculectomy with iridocycloretraction. Yet, modified trabeculectomy may be recommended also to patients with neovascular glaucoma, on condition that the procedure is preceded by effective surgery which eliminates or reduces neovascularization of the iris and the anterior chamber angle // Russian Ophthalmological Journal, 2016; 3: 5-11. doi: 10.21516/2072-0076-2016-9-3-5-11.