Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 4768
  • Home
  • Print this page
  • Email this page

   Table of Contents      
ARTICLES
Year : 1982  |  Volume : 30  |  Issue : 5  |  Page : 433-434

Trabeculectomy combined with anterior vitreous aspiration in aphakic obstructive glaucoma


Deptt. of Ophthlamology, Medical College, Jaipur, India

Correspondence Address:
R G Sharma
, Deptt. of Ophthalmology Medical College, Jaipur (Rajasthan)
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

How to cite this article:
Sharma R G. Trabeculectomy combined with anterior vitreous aspiration in aphakic obstructive glaucoma. Indian J Ophthalmol 1982;30:433-4

How to cite this URL:
Sharma R G. Trabeculectomy combined with anterior vitreous aspiration in aphakic obstructive glaucoma. Indian J Ophthalmol [serial online] 1982 [cited 2020 Nov 27];30:433-4. Available from: https://www.ijo.in/text.asp?1982/30/5/433/29219

table 1

Click here to view
table 1

Click here to view
Aphakic glaucoma has always been a complex and difficult problem for ophthalmic surgeons to manage.

The present study of Trabeculectomy combined with anterior vitreous aspiration sounds promising in that it seeks to open a new filtering channel for the drainage of aqueous with removal of an obstructive tissue (exudative membrane and vitreous etc.).


  Materials and methods Top


25 cases of aphakic obstructive glaucoma were subjected for Trabeculectomy combined with anterior vitreous aspiration.

Prior to surgery these cases were thoroughly examined including vision, fundus examination, tonometry and slit lamp biomicroscopy and gonioscopy, wherever it could be possible. Due to corneal pathology details of anterior -chamber angle was not visible in majority of the cases. Intraocular pressure was lowered by giving acetazolamide (250 mg. B.D. or T.D.S.), or intravenous Mannitol. Trabeculectomy was performed according to Watson's modification of Cairn's technique. Anterior vitrectomy was accomplished by Vannas scissors and 0.5 to 1.0 ml. of vitreous aspirated from anterior chamber through the same wound by 18 guaze canula attached to 2 c.c. hypodermic syringe, till the chamber was cleared of vitreous and cornea became scaphoid.

Postoperatively diamox was given in those cases in which initial intraocular pressure was very much high. Postoperative dressings were done as that of any other intraocular surgery. Follow up of these cases were 'carried out for a period of 6 months.


  Observations Top


Out of 25 cases, 18 cases had vitreous in anterior chamber and rest of 7 cases had pupillary block by exudative membrane.

It was observed that initial intraocular pressure is inversely proportional to the depth of anterior chamber with maximum number of cases 12 out of 25 with :ntra­ocular pressure ranging from 31 to 40 mm of Hg. had shallow anterior chamber. Post­operative response in these patients was very much satisfactory as all the cases achieved normal depth of anterior chamber. [Table - 1]

4 cases had postoperative complication. 3 cases had shallow anterior chamber with vitreous in anterior chamber and one case with flat anterior chamber. One case had hyphaema which absorbed after 5 days. One case had postoperative iridocyclitis which controlled with medical treatment.

Filteration bleb was found healthy in all the cases. The filteration bleb was thin and flat in 23 cases and uniformly thick and raised in 3 cases. None of the blebs in 25 cases were atrophied or showed cystic changes.

Most of the patients had visual acuity reduced to perception of light preoperatively. Post operatively visual acuity improved maximum upto 5/60.


  Discussion Top


Post operatively in 21 cases intraocular pressure was well controlled i.e., below 20 mm. of Hg suggested thereby the success rates of as 84% success rate in individual group was as follows : in group I of 3 cases (20-30 mm of Hg.) 66.66%; in group 11 of 12 cases (31-40 mm of Hg) 100% and

group III of 8 cases (41 to 50 mm of Hg.) 87.5%, while in group of 2 cases in which initial intraocular pressure was above 51 mm of Hg. the procedure was totally unsuccessful.

In 4 cases, out of 25 cases where surgery was not successful in controlling intraocular pressure might be due to high initial intrao­cular pressure, long duration and post operative hyphaema, iridocyclitis, vitreous in anterior chamber and flat and shallow anterior chamber.

It seems to be relatively a better surgical procedure in controlling the I.O.P. and being more physiological has a higher success rate with less postoperative complications. It can be therefore, safely advocated in most of the obstructive aphakic glaucoma in relieving the symptoms and partly improving the vision by clearing the cornea and controlling the intraocular pressure.


  Summary Top


The evaluation of Trabeculectomy com­bined with anterior vitreous aspiration in aphakic obstructive glaucoma cases was done in 25 cases.



 
 
    Tables

  [Table - 1]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Materials and me...
Observations
Discussion
Summary
Article Tables

 Article Access Statistics
    Viewed1204    
    Printed48    
    Emailed0    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal