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Abstract #53932 Published in IGR 15-2
Ab-interno peripheral iridectomy for the management of iris incarceration following deep sclerectomy
Reis GM; Clement CIClinical and Experimental Ophthalmology 2014; 42: 291-292
Deep sclerectomy (DS) and viscocanalostomy (VC) are surgical techniques that aim to lower intraocular pressure (IOP) by increasing aqueous humour outflow via Schlemm's canal, the suprachoroidal space, intra-scleral pathways and/or the sub-conjunctiva. A defining feature of DS and VC is preservation of the inner wall of Schlemm's canal. The lack of full-thickness incision into the anterior chamber (AC) avoids: i) sudden intra-operative and/or post-operative decompression of the eye, and ii) the need for surgical iridectomy. Micro-perforation into the AC may occur but in the absence of iris incarceration, post-operative topical pilocarpine is sufficient to manage this. Uncommonly iris incarceration may occur post-operatively, (1-2) leading to elevated IOP and surgery failure, necessitating revision of surgery with surgical iridectomy to correct. We describe, for the first time, an ab-interno peripheral iridectomy technique using a 23-gauge vitrectomy cutter to re-establish aqueous flow and avoid the need for surgical revision following iris incarceration complicating DS and VC.
Glaucoma Unit, Sydney Eye Hospital, 8 Macquarie st., Sydney, 2000, NSW, Australia.
Full articleClassification:
12.7 Surgical iridectomy (Part of: 12 Surgical treatment)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
2.8 Iris (Part of: 2 Anatomical structures in glaucoma)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
