Year : 1982 | Volume
: 30 | Issue : 5 | Page : 435--436
Vitrectomy in aphakic glaucoma
P Namperumalsamy, Taraprasad Das
Arvind Eve Hospital, Madurai, India
Aravind Eye Hospital, A.A. Nagar, Madurai 525 020,Tamil nadu
|How to cite this article:|
Namperumalsamy P, Das T. Vitrectomy in aphakic glaucoma.Indian J Ophthalmol 1982;30:435-436
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Namperumalsamy P, Das T. Vitrectomy in aphakic glaucoma. Indian J Ophthalmol [serial online] 1982 [cited 2021 Jan 19 ];30:435-436
Available from: https://www.ijo.in/text.asp?1982/30/5/435/29220
Filtering operations in aphakic glaucomas often fail due to vitreous blocking the drainage channels. Therefore, freeing the anterior chamber of vitreous could improve the chances of success in such cases. In this paper we are presenting a series of 14 patients who have undergone combined vitrectomy and filtering procedures; the surgical technique and the preliminary results are also presented.
MATERIALS AND METHODS
At Aravind Eye Hospital we have done Pars Plana Vitrectomy in 362 cases. Among them vitrectomy has been done for aphakic glaucoma either alone or combined with other anti-glaucoma procedures for 14 eyes.
Causes of Aphakic glaucoma in our cases were Primary open angle glaucoma 5, Pupillary block with vitreous 4, Glaucoma with membranes 2 and Glaucoma with epithelialization of the anterior chamber 3.
In cases of pupillary block with vitreous, surgery is considered only when the routine medical treatment has failed.
We did various Surgical procedures in these eyes as Vitrectomy with cyclodialysis (7), Vitrectomy with trabeculectomy (3), Membranectomy (3) and Vitrectomy (1).
Only anterior vitreous was removed through a pars plana approach using Peyman's Vitrephage. Cyclodialysis was performed through the same sclerotomy wound. The sclerotomy was placed concentric to the limbus in all cases. It was 3.5mm long placed 4.
mm behind the libus.
OBSERVATIONS AND DISCUSSION
The intraocular tension was effectively conrolled in 77% (10 cases with no complications. The mean preoperative intra oculartension was 36.6mm Hg and the mean intra ocular tension after surgery was 15 4 mm Hg. Where the intraocular pressure could not be controlled after surgery, 2 were treated medically with 2% Pilocarpine. In one case the tension could not be controlled due to rabeosis iridis and cyclocryotherapy has been done but without success still. There were no complications during or after surgery.
In our series cyclodialysis with vitrectomy have been d ne in seven cases and out of which the tension is well controlled in five cases. The higher success rate in these patients may be attributed to (1) removal of the vitreous from the anterior chamber and also relieving the vitreous incarceration from the wound (2) removal of the blood which may be seen in the anterior chamber after cyclodialysis and (3) removal of the solid vitreous behind the iris may cause falling backwards of the iris and ciliary body to keep the cleavage open. In one case the retained lens material was removed by membranectomy which relieved the intraocular tension. If there has been a pupillaryblock glaucoma associated with the presence of peripheral anterior synechiae all round, a vitrectomy with trabeculectomy has given better results in our series.
Vitrectomy alone or vitrectomy combined with trabeculectomy or cyclodialysis in 14 eyes having different types of aphakic glaucoma have been done. The success rate as far as the lowering of the intra ocular tension was concerned has been 77% (10 patients) without complications.