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Abstract #10222 Published in IGR 6-1
Concave trabeculo-Descemet's membrane as an early sign of viscocanalostomy failure
Negri-Aranguren IC; Devoto M; Dolzani DY; Sea SI; Grigera DE; Acosta JJournal of Cataract and Refractive Surgery 2004; 30: 826-831
PURPOSE: To correlate trabeculo-Descemet's membrane (TDM) changes with a late rise in intraocular pressure (IOP) in patients with successful viscocanalostomy. SETTING: Consultores Oftalmologicos, Hospital Oftalmologico Santa Lucia, and Centro de Estudios Medicos e Investigacion, Buenos Aires. METHODS: Patients who had a viscocanalostomy between July 1998 and September 2001 were studied retrospectively. Gonioscopy was performed in all patients. A subgroup of patients who had a late increase in IOP and were successfully treated with Nd:YAG laser goniopuncture were studied to correlate gonioscopic findings. Ultrasound biomicroscopy was performed in ten cases. Intraocular pressure measurements were taken before viscocanalostomy and before and after Nd:YAG treatment. RESULTS: Sixty-eight eyes of 48 patients had a viscocanalostomy to control IOP. Twenty-six eyes had a late increase in IOP and were successfully treated with Nd:YAG laser goniopuncture. Before goniopuncture, 17 eyes (65.30%) had a concave TDM. The mean IOP in these patients increased from 14.27 to 18.73 mmHg (range, 14-27 mmHg). Goniopuncture was performed a mean of 10.7 months (range, ONE to 36 months) after surgery. After Nd:YAG treatment, TDM was flat in all patients who had had a concave TDM before treatment. At the last examination, mean IOP was 13.8 mmHg, a mean decrease of 52.24% from baseline preoperative IOP; 61.5% of eyes had a final IOP of 14.0 mmHg or lower. CONCLUSIONS: A concave TDM is associated with a late rise in IOP. TDM was flat after laser goniopuncture and normalization of IOP.
Dr. I.C. Negri-Aranguren, Consultores Oftalmologicos, Buenos Aires, Argentina
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
