|Year : 1979 | Volume
| Issue : 4 | Page : 164
Scleroencliesis (a scleral implant for glaucoma)
Ramesh Rohatgi, Rajendra Rohatgi, SK Srivastava
Eye Hospital, Kanpur, India
Deputy Chief Medical Officer, Eye Hospital, Kanpur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rohatgi R, Rohatgi R, Srivastava S K. Scleroencliesis (a scleral implant for glaucoma). Indian J Ophthalmol 1979;27:164
|How to cite this URL:|
Rohatgi R, Rohatgi R, Srivastava S K. Scleroencliesis (a scleral implant for glaucoma). Indian J Ophthalmol [serial online] 1979 [cited 2020 Jun 5];27:164. Available from: http://www.ijo.in/text.asp?1979/27/4/164/32614
Placing an implant across a limbal section to drain the aqueous from the anterior chamber to the subconjunctival space is one of the techniques of surgery for glaucoma. The long term results have been disappointing. The implants (teflon, acrylic) usually are not tolerated.
| Materials and Methods|| |
Selection of cases
The eyes having tension of more than 40 mm of Hg. and no P.L. were selected as the study is in experimental stages.
A pye (Greek alphabet) shaped homoscleral implant, preserved in glycerine at-4°C was placed under a conjunctival flap across 12 O'clock meridian in such a way that the two vertical legs (2.5 mm x 1.5 mm) were passing through a limbal section to reach the anterior chamber. At the midpoint of the horizontal limbus (8mmx5mm) a 3 mm punch was made.
All the eyes having tension range upto 25 mm. Hg. were considered to be controlled.
A total of 49 eyes of obsolute glaucoma were operated and scleral implant was put, out of which 35 (71.4%) were males and 14 (2.6%) were female. But during follow up only 35 males (94.2%) and 12 (85.7%) females came regularly upto 3 months. Thus total cases followed were 45 (91.8%) while 4 (8.2%) did not turn up for follow up.
It is clear [Table - 1] that over all success in 45 cases followed up till 3 months was 73.3% (33 cases) Success rate was better in males (75.7%) as compared to females (66.6%).
As regards complications, we encountered them in only 13 cases (28.8%) out of 45 cases. Flat chamber was in 2 cases (4 4%) while mild uveitis was in I I cases
(24.4). Flat chamber was restored by giving acetazolamide 250 mg, tablets three times a day in 3-4 days time. Uveitis was controlled by instillation of atropine 1% eye ointment, dexamethasone eye drops and systemic steroids.
There were no signs of any reaction except moderate congestion at the site of bleb which diminished by intillation of dexamethasone eye drops. There was bleb formations by 4-6 weeks and in 3 months it was well formed.
| Discussion|| |
There have been many attempts to produce a filtering prosthesis in an attempt to normalise the ocular tension. But all these prosthesises either caused pressure atrophy or intense tissue reaction or there was outright rejection of the prosthesis.
This study proves that the scleral grafts are very well accepted by the eye. That the presence of scleral tissue (preserved) in the anterior chamber does not cause any untoward reaction.
This procedure causes the least distortion and damage of the ocular tissue and also controls the raised intraocular tension successfully.
The study is still in its initial stages and further work as to the fate of the graft after 6 months to a year is to be followed.
[Table - 1]