Topographical features of the formation of outflow tracts with the use of spongy allo-drainages in glaucoma

Abstract

PURPOSE. Improving the results of the operation and achieving its reliability in secondary glaucoma, including refractory glaucoma, can be done using a non-biodestructible allograft drainage with spongy structure fabricated by Alloplant® technology.METHODS. Experimental and morphological studies conducted in the Russian Eye and Plastic Surgery Center showed that the allogeneic spongy biomaterial used for anti-glaucoma sponge drainage surgery is gradually replaced by loose tissue with a porous structure, similar to trabecular, forming a new drainage system. During the operation, the proximal part of the drainage is inserted through the excised drainage zone in the anterior chamber angle (ACA). The distal part is tucked into the suprachoroidal space through a linear incision in the scleral bed.RESULTS. The newly created topography of the ACA after sponge drainage operation with the use of allogeneic biomaterial features not only the expansion of the ACA profile, but also the replacement of the excised part of the drainage zone with biomaterial after sinus trabeculectomy (STE) and elimination of retention of the intraocular fluid (IOF) outflow. Ultrasound biomicroscopy (UBM) performed at various times after antiglaucoma surgery showed that the microtubule system preserved. Optical coherence tomography (OCT) of the ACA demonstrates the location of the drainage in the long-term follow-up.CONCLUSION. Antiglaucoma operation with the use of allogeneic biomaterial with spongy structure promotes the formation of trabecula-like tissue in the ACA, eliminates retention of IOF outflow, and reduces the risk of scleroscleral and sclero-conjunctival adhesions.