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ARTICLES
Year : 1979  |  Volume : 27  |  Issue : 4  |  Page : 162-163

Combined trabeculectomy and cyclodialysis in aphakic glaucoma


Eye Hospital, Navsari (Gujarat), India

Correspondence Address:
O P Billore
Rotary Eye Institute, Smt. Lilavatiben Mohan Lal Shah Eye Hospital, Navsari (Gujarat)
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Billore O P, Shroff A P, Desai R G. Combined trabeculectomy and cyclodialysis in aphakic glaucoma. Indian J Ophthalmol 1979;27:162-3

How to cite this URL:
Billore O P, Shroff A P, Desai R G. Combined trabeculectomy and cyclodialysis in aphakic glaucoma. Indian J Ophthalmol [serial online] 1979 [cited 2020 Aug 13];27:162-3. Available from: http://www.ijo.in/text.asp?1979/27/4/162/32613

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Table 3

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Table 2

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Table 1

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Table 1

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Surgical management of glaucoma in aphakics has been both difficut and unsatis­factory.

Cyclodialysis is the method, which is being commonly used, but becuase of its higher failure rate and complications, a variety of other methods have been suggested by different workers[4].

None of them have become popular because of their unpredictable nature. Trabeculectomy nowadays seem to have become the procedure of choice in all types of glaucomas. We have tried to compare the results of cyclodialysis, trabeculectomy and combined cyclodialysis and trabeculectomy procedure in aphakic glaucomas.


  Materials and Methods Top


In the present series for control study classical cyclodialysis (in outer temporal quadrant at 8 mm. from the limbus) has been performed in 10 cases of aphakic glaucoma. Microscopic subscleral trabeculectomy is performed in 10 cases of aphakic glaucoma. In most of the cases surgery was preferred at 12 O'clock position but in cases in which filtration surgery was done previously then it was done in the other quadrant. Sub­scleral trabeculectomy with cyclodialysis has been tried in 40 cases of aphakic glaucoma. A conjunctival incision from 10 to 2 o'clock position concentric with the limbus was made and flap was reflected over the cornea. A partial thickness scleral incision was made parallel and concentric to the limbus. At the end of this two vertical incision were made towards the limbus base. The sclera was dissected with Rawky Knife, and reflected over the cornea. A 4 mm. incision is made along at this stage. With the Barraquers tooth forceps one lip of subscleral tissue is grasped and cut with Vanna's scissors. It is presumed that this excised portion j will contain a length of schlemn's canal with its trabe­cular meshwork. Iridectomy was done in almost all cases. Now cyclodialysis spatula was passed through the window, between sclera and ciliary body and was swept about 45° in the anterior chamber on either side. Then corneoscleral flap was sutured with interrupted sutures and conjunctiva and stitched with continuous suture.


  Observations and comments Top


In cyclodialysis series it was observed, that tension was controlled successfully in 60% cases, while in trabeculectomy and combine pro­cedure it was 80% and 90% respectively [Table - 1]. Among the cases with controlled ocular tension a high order (16-20 mmHg) I.O.P. was observed in 40% of cases op: rated for cyclodia­lysis, as compared to 20% in cyclodialysis and trabeculectomy and 10% of trabeculectomy alone [Table - 2]. On the other hand moderate (11-15mmHg) intraocular pressure was main­tained in majority (65%) of combined procedure, 50% of trabeculectomy alone and only 20% with cyclodialysis alone. From [Table - 3] it is clear that tension above 50mm of Hg. schiotz also can be controlled by cyclodialysis and com­bined procedure. Tension between 36 to 50mm is well controlled by trabeculectomy and com­bined procedure (83%) each. rension between 24 and 35 mm is well controlled by trabeculec­tomy and combined surgery (100%).

By combined trabeculectomy and cyclodia­lysis method in aphakic glaucoma intraocular, tension is controlled better as compared to cyclodialysis and trabeculectomy alone.

 
  References Top

1.
Allen, J.H., 1951, 5th Med. J. Bgham, Ala, 44,, 931.  Back to cited text no. 1
    
2.
Backer, Schaffer, 1976, Diognosis and Therapy of Glaucoma.  Back to cited text no. 2
    
3.
Stallard, H.B., 1973, Textbook of Eye Surgery Indian Edition K.M. Varghese Co. Bombay.  Back to cited text no. 3
    
4.
Wolfe O.R., & Blaces, 1944, Amer. J. Ophthal., 27, 1146.  Back to cited text no. 4
    



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3]



 

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