|Year : 1983 | Volume
| Issue : 5 | Page : 642-644
Trabeculectomy combined with pars plana vitrectomy in aphakic glaucoma (a comparative study)
OP Billore, AP Shroff, CB Patel
Rotary Eye Institute Navsari, Dudhia Talao, Navsari, India
O P Billore
Rotary Eye Institute Navsari, Dudhia Talao, Navsari
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Billore O P, Shroff A P, Patel C B. Trabeculectomy combined with pars plana vitrectomy in aphakic glaucoma (a comparative study). Indian J Ophthalmol 1983;31:642-4
|How to cite this URL:|
Billore O P, Shroff A P, Patel C B. Trabeculectomy combined with pars plana vitrectomy in aphakic glaucoma (a comparative study). Indian J Ophthalmol [serial online] 1983 [cited 2020 Sep 28];31:642-4. Available from: http://www.ijo.in/text.asp?1983/31/5/642/36617
In our previous work  we have reported results of combined trabecule,etomy and cyclodialysis in aphakic glaucoma. In the present study we have done pars plana vitrectomy with trabeculectomy in aphakic glaucoma. This study was compared with (A) Trabeculectomy . combined with anterior vitrectomy and (B) pars plana vitrectomy combined with cyclodialysis.
| Material and Methods|| |
In the present series aphakic glaucoma with vitreous in anterior chamber were selected for pars plana vitrectomy combined with trabeculectomy. For Pars Plana vitrectomy Peyman's vitrophage fitted in Dr. Nagpal's vitrectomy console was used. Results of this, group were compared with (a) trabeculectomy combined with anterior vitrectomy and (b) pars plana vitrectomy combined with cyclodialysis. In each group 10 cases of aphakic glaucoma were studied and follow up was done up to 6 months. A scleral bed measure 6 mm x 4 mm was prepared at 12° clock position. 6" x 4" and sclerotomy was done from the limbus. Mattress suture were applied after diathermy over scleral lip so that choroid knuckle protrude out. Stab incision was given with van Graefe's knife and Peyman's vitrophage was introduced in the vitreous cavity. As vitreous is being cut out in the posterior chamber and pupillary area, the Iris falls back and anterior chamber is formed. Then cutting is withdrawn and sclerotomy wound is closed. Episcleral bed is dissected further and 4 x 2 mm; episcleral tissue is cut, iridectomy is done. Scleral flap and conjunctiva is stitched as usual.
| Observation|| |
From the [Table - 1] it, was, observed that success rate with pars plana vitrectomy combined with trabeculectomy is higher (90°) than cyoclodialysis (70°) and frabeculectomy combined with anterior vitrectomy (80°) procedure.
Vitreous can be cut nicely with pars plana vitrectomy and cutter can be introduced in to the anterior chamber by making broad iridectomy with the cutter and vitreous can be cleared from anterior chamber also. Trabeculectomy combined with anterior vitrectomy helps in clearing the vitreous in the anterior chamber and pupillary area only.
If it is a fluid vitreous then it is sucked with the syringe fitted with the canula. From the [Table - 2] it appears that post operative control of tension at high order (16-20 mm) was noted in trabeculectomy combined with anterior vitrectomy (50%) as compared to other procedures. Moderate intraocular pressure was maintained by trabeculectomy combined with pars plana vitrectomy and other two procedures. Tension was on lower side less than 10 mm as compared to trabeculectomy combined with anterior vitrectomy. From the [Table - 3] it was observed that pre operative tension above 50 is better controlled with pars plana vitrectomy combined with trabeculectomy as compared to other two procedures. 36 to 50 mm of range was controlled equally good in all the procedures.
| Discussion|| |
Pars plana vitrectomy combined with trabeculectomy helps in cleaning the vitreous from the pupillary area, posterior chamber and anterior chamber in a much better way as compared to anterior vitrectomy procedure. Vitrectomy combined with cyclodialysis does not clear the solid vitreous as fully as the other procedure mentioned previously. Pars Plana vitrectomy combined with trabeculectomy clears the portion of the solid vitreous and iris diaphragm falls back nicely when it is performed in a flat chamber. Anterior segment reconstruction is nicely done with this procedure. Even higher range of tension is better controlled with pars plana vitrectomy combined with trabeculectomy [Table - 3]. Success rate in aphakic glaucoma is better with Pars Plana vitrectomy as compared to other two procedure [Table - 1].
| Summary|| |
Pars Plana vitrectomy was done in aphakia glaucoma and results were better than other two procedures studied.
| References|| |
Billore, O.P., Shroff, A P., & R.G., Desai, Combined trabeculectomy and cyclodialysis in aphakic glaucoma, Ind. I. Ophthal., IV 162,1979.
[Table - 1], [Table - 2], [Table - 3]