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Abstract #18320 Published in IGR 3-3
Optimal timing for glaucoma surgery
Baudouin CJournal Français d'Ophtalmologie 2001; 24: 1103-1109
The medical treatment of primary open-angle glaucoma has become progressively more and more efficient and safe, and surgery is therefore mostly restricted to failure of, and intolerance to, antiglaucoma eyedrops. Thus, glaucoma surgery may cause severe complications, and a high risk of failure has tempered its prognostics. Nevertheless, when efficacious, glaucoma surgery definitively resolves two major pitfalls of medical treatment: patient compliance and tolerance to eyedrops. Moreover, new surgical developments have been incorporated from the new technique of non-penetrating deep sclerectomy, which is actually an external trabeculectomy involving removal of the area of maximum resistance to aqueous outflow. This procedure has a very low risk of complications, much lower than that of standard trabeculectomy, but its efficacy is still controversial. Whatever the technique chosen for filtering surgery, antimetabolites may be used in order to limit the risk of postoperative fibrosis, but they also expose the patient to specific, sometimes sight-threatening, complications. Therefore, the most important, and also the most difficult, choice for treating glaucoma patients still remains the best timing for surgery, either excessive, ineffective, or aggressive medical treatment, or systematic primary surgery. LA: French
Dr C. Baudouin, CHNO des Quinze-Vingts, 28 rue de Charenton, 75012 Paris, France
Classification:
12.1 General management, indication (Part of: 12 Surgical treatment)
