Chapter 243 – Complications of Glaucoma Surgery and Their Management

Chapter 243 – Complications of Glaucoma Surgery and Their Management   J. WILLIAM DOYLE M. FRAN SMITH   INTRODUCTION In the ideal world, surgery proceeds smoothly and outcomes are uncomplicated. Unfortunately, in the real world, despite a surgeon’s best efforts, complications may occur. This is especially true in the field of glaucoma—glaucoma surgery, unlike many […]

Chapter 242 – Drainage Implants

Chapter 242 – Drainage Implants   JEFFREY FREEDMAN           DEFINITION • Surgical method for dealing with refractory glaucomas.   KEY FEATURES • Drainage plate attached to silicone tube. • Varying plate size and number. • Indications. • Surgical method of insertion. • Complications.   ASSOCIATED FEATURE • Outcomes.       […]

Chapter 241 – Antifibrotic Agents in Glaucoma Surgery

Chapter 241 – Antifibrotic Agents in Glaucoma Surgery   1596   PENG TEE KHAW LYDIA CHANG   INTRODUCTION One of the major areas of advance in the surgical management of glaucoma over the past 20 years has been the use of antimetabolites to prevent scarring after glaucoma filtration surgery. Antimetabolites have gone from occasional use […]

Chapter 240 – Trabeculectomy

Chapter 240 – Trabeculectomy   RONALD L. FELLMAN           DEFINITION • Trabeculectomy, a guarded filtration procedure, remains the “gold standard” for long-lasting intraocular pressure reduction in uncontrolled primary glaucoma.   KEY FEATURES • Patients expect a “quick fix” but glaucoma surgery is high in risk and requires exhaustive preoperative counseling and […]

Chapter 239 – Nonpenetrating Glaucoma Surgery

Chapter 239 – Nonpenetrating Glaucoma Surgery   ELIE DAHAN TAREK SHAARAWY ANDRE MERMOUD JEFFREY FREEDMAN           DEFINITION • Nonpenetrating glaucoma surgery (NPGS) refers to drainage procedures that restore aqueous humor filtration through a natural membrane, namely the trabecular meshwork. NPGS includes all the different surgical techniques previously named: trabeculectomy ab-externo, nonpenetrating […]

Chapter 238 – Goniotomy and Trabeculotomy

Chapter 238 – Goniotomy and Trabeculotomy   JAMES D. BRANDT   INTRODUCTION Congenital and pediatric glaucomas are generally regarded as surgical, not medical, disorders because medical therapy alone is rarely effective for these conditions and current techniques of surgery on the anterior chamber angle (goniotomy and trabeculotomy) enjoy a high degree of success. In this […]

Chapter 237 – Cyclodestructive Procedures in Glaucoma

Chapter 237 – Cyclodestructive Procedures in Glaucoma   UNDRAA ALTANGEREL MARLENE R. MOSTER TAREK M. EID   INTRODUCTION The goal of glaucoma surgery is to lower the intraocular pressure (IOP) predictably, either by maximizing outflow (as in filtration and tube-shunt surgery) or by decreasing inflow (as with cyclodestructive procedures). The destruction of the ciliary body […]

Chapter 236 – Laser Filtration Procedures

Chapter 236 – Laser Filtration Procedures   MARTHA MOTUZ LEEN   INTRODUCTION Laser energy can be delivered either internally (ab interno) or externally (ab externo) to produce a direct opening into the anterior chamber through limbal tissue to achieve filtration. The laser energy may be delivered using a probe (contact) or a gonioscopy lens (noncontact). […]

Chapter 235 – Argon Laser Trabeculoplasty and Peripheral Iridectomy

Chapter 235 – Argon Laser Trabeculoplasty and Peripheral Iridectomy   IOANNIS M. ASLANIDES L. JAY KATZ   ARGON LASER TRABECULOPLASTY INTRODUCTION AND HISTORICAL REVIEW Argon laser trabeculoplasty (ALT) is an established, well-tolerated procedure used to lower intraocular pressure (IOP) in various types of open-angle glaucoma.[1] (Laser treatment of the human trabecular meshwork by puncturing Schlemm’s […]

Chapter 234 – New (Pending) Glaucoma Medical Therapy

Chapter 234 – New (Pending) Glaucoma Medical Therapy   WILLIAM C. STEWART   INTRODUCTION Ophthalmologists are fortunate to witness the introduction in recent years of several new pharmaceutical products to help manage elevated intraocular pressure (IOP). In general, these drugs are new compounds within existing classes of medicines already in use or combinations of currently […]