|Year : 1981 | Volume
| Issue : 3 | Page : 227-228
Clinical evaluation of trabeculectomy operation in aphakit glaucoma
Sohan Lal Sharma, Tarlochan Singh
Medical College, Patiala, India
Sohan Lal Sharma
Medical College, Patiala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma S, Singh T. Clinical evaluation of trabeculectomy operation in aphakit glaucoma. Indian J Ophthalmol 1981;29:227-8
In the surgical treatment of aphakic glaucoma cyclodialysis had so far remained the most popular. This operation often fails to bring down the tension and is known to produce a number of complications. Recently trabeculectomy has been successfully tried in cases of aphakic glaucoma.
| Materials and methods|| |
25 patients of aphakia with raised intraocular tension after more than three months of cataract operation were selected from the Out Patient Department of Rajendra Hospital, Patiala for this study. A detailed ocular examination including slit lamp, gonioscopy fields was done.
All the patients were operated under local anaesthesia and trabeculectomy operation was done at 12 O'clock meridian using the standard technique. The patient was discharged on the 5th or 6th post operative day and were reexamined on the 15th, 30th 45th and 60th post operative day.
| Observations|| |
A total of 25 patients of aphakic glaucoma were studied. The operation was considered successful if the intraocular pressure came down to below 22 mm. Hg. (Schiotz). The Intraocular pressure was above 22 mm./Hg, these patients were put on miotics and carbonic anhydrase inhibitors. Of these 25 patients, 17 were males and 8 were females and the ages ranged from 50-80. 23 eyes showed preoperative corneal cedema and shallow chambers. Vitreous was present in the Anterial chamber in 2 cases. Gonioscopy showed peripheral anterior synechia in 15 cases having pigmentation of trabecular muscle break in 2 cases and vitreous in carceration. Preoperatively these cases showed normal angle. They were probably cases of chronic simple glaucoma.
The average preoperative intraocular pressure was 42.3 mm. of Hg. (Schiotz) [Table - 1].
5 patients had visual acuuy between 6/24 and 6/36 and the rest of had a visual acuity of 6/60 or below.
Various post operative complications encountered were Iritis (Mild) 9 cases (36%) Hyphaema 4 cases (16%) and Shallow Anterior Chamber 2 cases (8%) In all the nine cases of iridocyclitis, inflammation was soon brought under control with the use of local atropine and corticosteroid drops. The anterior chamber was well formed in the second post operative day in 15 cases (50%) while it formed on the 5th day in another 7 cases (28%) and on the 16th day in one cases (4%). Only 2 cases (8%) showed very shallow anterior chamber even after two months of operation. Hyphaema which occurred in 4 cases (16%) which settled within 15 days without any ill effects.
The post operative intraocular pressure was controlled with surgery alone in 21 cases (84%) controlled with surgery supplemented with medication in 2 (8%) while it-remained uncontrolled in 2 cases (8%).
21 patients showed some degree of bleb formation while there was no demonstrablebleb in 4 cases. All the 21 cases where bleb had developed showed controlled post operative intraocular pressure. Among the remaining 4 cases where no bleb could be seen, two still had controlled intraocular pressure while in the remaining two the intraocular pressure remained above normal level.
There was no appreciable improvement in visual acuity postoperatively.
| Discussion|| |
In the present study 21 cases showed a control of 20%, and in another 2 cases the control was achieved with the addition of medical therapy. In 8% cases the intraocular pressure could not be controlled. No serious complications were encountered. The only complication of mild iritis and hyphaema cleared easily and in only one case (4%) the anterior chamber remained flat for over two months of operation.
| Summary|| |
25 patients of aphakic glaucoma were treated with trabeculectomy operation and their results studied. In 21 cases the intraocular pressure was brought down to normal by surgery alone.
| References|| |
Cairns, J.E., 1968, Amr. J. Ophthalmol. 66:673
[Table - 1]