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Abstract #8841 Published in IGR 5-1
The failure causes of non-penetrating trabecular surgery and reoperation
Wang Y; Sun X; Meng F; Wang JChinese Journal of Ophthalmology 2003; 39: 87-
OBJECTIVE: To study the causes of failure of nonpenetrating trabecular surgery (NPTS) with SKGeL (a hyaluronic acid biological gel) implantation, and the surgical method of reoperation. METHODS: Repeated operation with mitomycin (MMC) through the initial surgical site was performed in 13 failed cases (13 eyes) that had undergone NPTS with SKGeL implantation. The blockage in the filtration tract was removed and the anterior chamber remained intact during surgery. All these cases were open angle glaucoma. Before reoperation, ultrasound biomicroscopic (UBM) examination was performed on the primary filtering bleb, and intraocular pressure (IOP) examination followed reoperation. RESULTS: The mean follow-up period was 14.0 ± 5.8 months (6-24 months). UBM examination showed that the filtering bleb disappeared and that there was a liquid chamber under the superficial scleral flap in all cases of failure. Filtration failure due to scarring at the conjunctiva-tenon's capsule-superficial scleral flap interface was seen in nine cases, proliferative membrane formation on the trabecular surface in three cases, and micropenetration of the trabecula in one case. At the end of follow-up, the IOP of ten cases was lower than 21 mmHg without medication, mean IOP level was 14.1 ± 3.7 mmHg, IOP of one case was 15 mmHg with Betagen, and two further cases were still failures six months after reoperation and finally underwent trabeculectomy. Complications included hyphema in one case and micropenetration of the trabecula in one case. CONCLUSIONS: Scarring at the conjunctiva-tenon's capsule-superficial scleral flap interface was the most important cause of failure in NPTS with SKGeL implantation. Reoperation with MMC through the initial surgical site could be a choice for these failed cases.LA: Chinese
Dr. X. Sun, Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai 200031, China. Sunxinghuai@163.com
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
