Year : 1983 | Volume
: 31 | Issue : 5 | Page : 698--699
Sub scleral posterior sclerectomy in secondary glaucoma following perforated corneal ulcer
US Srivastava, RN Tyagi, AK Jain, SK Garg
Gandhi Eye Hospital, Aligarh, India
U S Srivastava
Gandhi Eye Hospital, Aligarh
|How to cite this article:|
Srivastava U S, Tyagi R N, Jain A K, Garg S K. Sub scleral posterior sclerectomy in secondary glaucoma following perforated corneal ulcer.Indian J Ophthalmol 1983;31:698-699
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Srivastava U S, Tyagi R N, Jain A K, Garg S K. Sub scleral posterior sclerectomy in secondary glaucoma following perforated corneal ulcer. Indian J Ophthalmol [serial online] 1983 [cited 2020 Feb 21 ];31:698-699
Available from: http://www.ijo.in/text.asp?1983/31/5/698/36636
Development of secondary glaucoma following healing of perforated corneal ulcer is a common occurrence. The severity of this condition is dependent upon size and site of lesion. This condition, if not treated in time, invariably leads to complete loss of vision followed by development of unsightly eyes which becomes a social problem for the patient.
It is well known that the pathology of increased intra ocular tension, in such cases, lies in the mechanical blockage in the drainage. This blockage may either be due to the adhesions of the iris or the lens capsule to the corneal wound or both [Figure 1]. Medical treatment in such cases provides only transient relief. Permanent control of intraocular tension in such cases can only be obtained by performing a fistulising operation.
We did subscleral posterior sclerectomy with iredectomy in 59 cases with the primary aim to control the intra ocular tension and to salvage as much vision as possible at a later date.
Material and Method
59 such cases admitted in our hospital during the last 2 years were included in this study. These cases were divided into four groups depending upon the extent of corneal adhesions [Figure 1].
Group 1. Adhesions involving almost whole of the cornea.
Group 2. Adhesions involving nearly half of the peripheral cornea.
Group 3. Adhensions involving nearly half of the central cornea.
Group 4. Adhensions involving only central portion of the cornea.
The follow up period varied from 6 months to 2 years. The intra ocular tension was controlled in 47 cases out of 59 cases. The uncontrolled cases belonged to group 1 [Figure 2].
In all the fistulizing operations except sub-scleral post sclerectomy, the fistulous track is covered by conjunctiva and Tenon's capsule. This forms a raised cicatrix which is susceptible to trauma during future surgery on the same eye. Any trauma to cicatrix may nullify the effect of the filtering operation.
The fistulous track in sub scleral posterior sclerectomy besides controlling the intra ocular tension, is covered by superficial scleral lamellae in addition to the conjunctiva and Tenon's capsule. The flat cicatrix, so formed is less susceptible to injury and also does not cause irritation in cosmetic shell or haptic Contact lens wearers.
Subscleral posterior sclerectomy was done in 59 cases of secondary glaucoma following healing of perforated corneal ulcer. It failed only in 12 cases. Advantages of this operation over other fistulizing operations are discussed.