Оптимизация хирургического лечения вторичной закрытоугольной глаукомы у пациентов с органическим блоком угла передней камеры

Abstract

Purpose. Optimization of surgical treatment of secondary closed-angle glaucoma in patients with organic block of the anterior chamber angle. Material and methods. The analysis of the results of 6 AGO using autologous scleral drains treated with MMC is presented in children with an organic block of the anterior chamber angle without the phenomena of neovascularization is privided. Five children had uveal glaucoma; one child had an essential mesodermal iris dystrophy with secondary glaucoma. In all cases before the formation of autologous scleral drains, intraoperative applications of MMC were performed, followed by a plentiful washing of the operating field with normal saline solution. The duration of follow-up was from 1.5 to 7 years. Results. The operations proceeded without complications. There was a long choroidal edema on one eye in the early postoperative, stopped with the help of conservative treatment for 10 days. In the long term, on one eye in the period of exacerbation of uveitis, dislocation of autodrainages arose, which was facilitated by the appearance of exudative effusion in the anterior chamber. Later on this eye the failure of the AGO developed. On the other eyes, the intraocular pressure remained compensated, and the functions were stable. Conclusion. Treatment of drainages from the autosclera with MMC before implanting them into the anterior chamber of the eye, in patients with organic block of the anterior chamber angle, is effective against the hypotensive effect of the operation and is safe for intraocular structures while observing the processing technique. Key words: secondary closed-angle glaucoma, anterior chamber, autologous