By Ahmad A. Aref, Rohit Varma
This article offers professional guide at the thoughts at the moment hired for the surgical procedure of glaucomatous illness, masking either the host of novel microinvasive units for therapy of milder levels and the subtle innovations that improve good fortune charges in sufferers with complicated disorder. The severe steps in each one technique are in actual fact defined because of many fine quality illustrations and surgical video clips. Pearls and pitfalls of many of the recommendations are highlighted, and useful info is equipped on symptoms, preoperative issues, capability intra- and postoperative problems, and techniques for decreasing the occurrence of such adversarial occasions. each one therapy strategy is addressed in a committed stand-alone bankruptcy, making sure ease of reference for the practitioner. Readers will locate this ebook, written through across the world famous specialists within the box, to be a superb resource of up to date details on complicated glaucoma surgical concepts.
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Extra info for Advanced Glaucoma Surgery
Demonstrated significantly better IOP control and reduced use of ocular hypotensive medications, at 10 months follow-up, in patients receiving phacoemulsification surgery within 4 days of APAC versus conventional surgical iridectomy . Improved long-term results may be best if surgery is performed before PAS has had a chance to fully form. However, in cases where access to surgery is limited, preparative LPI may be a more viable option. It has been suggested that 50 % of PACG patients are likely to go on and develop cataracts due to ageing and the effects of glaucoma 35 treatment, and the latter in fact may accelerate cataract progression .
Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90:262–7. 2. Nogpiur M, Ku JY, Aung T. Angle closure glaucoma: a mechanistic review. Curr Opin Ophthalmol. 2011;22(2):96–101. 3. Wang B, Sakata LM, Friedman DS. Quantitative iris parameters and association with narrow angles. Ophthalmology. 2010;118:474–9. 4. Tsai A, Wong TT, Perera SA. The utility of anterior segment imaging in an atypical case of angle closure. In: Proceedings of Singapore Health Care, 2012.
Furthermore, the subject of effective lens position (ELP) in cases of phacoemulsification post APAC has been subject to debate. It may be possible that the IOL actually moves anteriorly as the capsule contracts and fibroses, with subsequent effects upon IOL calculation. The Holladay IOL Consultant (Jack T. Holladay, Houston, Tex) is commonly used to optimize outcomes as the formula includes anterior chamber depth and corneal diameter measurements in the IOL calculation. 1 Choice of Anaesthesia Ocular features that are likely to make surgery more challenging such as a small pupil, large bulky cataract, and reduced corneal clarity along with the presence of corneal guttata should be considered.