Evaluation of modified techniques of iridencleisis.

Nirankari, M.S.; Malhotra, G S

doi:10.1136/bjo.49.12.646

Cited by 4 publications

(4 citation statements)

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“…The method of choice in surgical treatment of pupillary block glaucoma is iridencleisis (Gelatt and Gelatt, 2001;Strubbe, 2002). It helps restore the flow of aqueous humour from the posterior chamber to the anterior chamber and further to the subconjunctival space by a window cut out in the sclera (Nirankari and Malhotra, 1965;Cook, 1997;Gelatt and Brooks, 1999;Gelatt and Gelatt, 2001;Strubbe, 2002). In the classic understanding of Weeker's or Holth's iridencleisis, this surgery involves making a small window in the sclera in the shape of a narrow fissure -anterior sclerectomy (Nirankari and Malhotra, 1965;Gupta et al, 1966).…”

Section: Resultsmentioning

confidence: 99%

“…The most common complications following iridencleisis include intraocular hemorrhage, posterior synechiae, iris pigment deposition on the lens capsule, cataract formation, intraocular infection, postoperative iridocyclitis, and closure of the iridencleisis (Nirankari and Malhotra, 1965;Gupta et al, 1966;Nagpaul et al, 1966;Gelatt and Brooks, 1999;Gelatt and Gelatt 2001;Strubbe, 2002). Of the complications mentioned above, only local posterior synechiae and iris pigment deposition on the lens capsule occurred during the eight months follow-up observations; these may well have been caused by uveitis from the pre-surgery period.…”

Section: Resultsmentioning

confidence: 99%

“…It is a procedure which combines the features of filtration and drainage and consists in incarceration of a portion of the iris in corneoscleral incision, thereby creating a filtering cicatrix. Various modifications of the procedure are known: Holth's or Weeker's techniques (Gupta et al, 1966), one or two-limb iridencleisis, or iridencleisis with sclerectomy (Nirankari and Malhotra, 1965).…”

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Combined iridencleisis and posterior sclerectomy in surgical treatment of glaucoma secondary to uveitis in a dog: a case report

Lew¹,

Lew²

2009

Vet. Med. - Czech

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ABSTRACT:In early diagnosed and causally treated cases of secondary glaucoma, it is possible to save the sight in a glaucomatous eye and to preserve the sight in a healthy eye. The most common causes of secondary glaucoma include anterior uveitis, in which diverse pathological processes can lead to an increase in IOP. In cases of treating glaucoma secondary to uveitis with annular posterior synechiae in connection with peripheral anterior synechiae, iridencleisis is the method of choice. This article presents the results of the eight-month treatment of such a case with iridencleisis combined with posterior sclerectomy. This method makes it possible to increase the area of aqueous humour outflow to the subconjunctival space. The treatment resulted in the reduction of IOP in the left eye from the preoperative value of 72 mmHg to 15 mmHg, which was maintained at a constant level during the eight-month period following the surgery. Sight assessment in the operated eye, carried out on the basis of PLR, menace and dazzle response, brought a moderately positive result.Keywords: iridencleisis; sclerectomy; secondary glaucoma; dog Secondary glaucoma is the most common form of glaucoma in dogs (Smith et al., 1993;Barnett et al., 2002;Barnett, 2006). Unlike primary glaucoma, it is not a hereditary disease, but its causes may be (Curtis and Barnett, 1980;Gelatt and Brooks, 1999;Johnsen et al., 2006). In contrast to primary glaucoma, secondary glaucoma may involve only one eye; therefore, if the primary disease is diagnosed and the treatment is started early enough, the patient may not lose vision (Johnsen et al., 2006).Among the most common causes of secondary glaucoma in dogs are, anterior uveitis (Crispin, 1988;Abrams, 2001;Johnsen et al., 2006), lens displacement (Curtis and Barnett, 1980;Abrams, 2001;Gelatt and Gelatt, 2001;Gelatt and MacKay, 2004;Morris and Dubielzig, 2005;Johnsen et al., 2006), intumescent cataract (phacomorphic glaucoma) (Gelatt and Brooks, 1999;Gelatt and MacKay, 2004), intraocular cysts (Deehr and Dubielzig, 1998;Spiess et al., 1998;Sapienza et al., 2000), hyphema (Nelms et al., 1993;Sansom et al., 1994;Barnett et al., 2002), intraocular neoplasia (Dubielzig, 1990), ocular melanosis (pigmentary glaucoma) (Petersen Jones, 1991;van de Sandt et al., 2003).An accurate estimate of the most common direct cause of secondary glaucoma in dogs is possible with retrospective statistical studies. Therefore, it is obvious that the longer the period under study, the more representative the results will be. The results of a retrospective study by Johnsen et al. (2006) of a 5-year period indicate that the direct cause of over three quarters of all the cases of secondary glaucoma in dogs are anterior uveitis and lens dislocation. With the estimation criteria narrowed down, nonsurgical anterior uveitis alone accounted for nearly 45% of the group of dogs. Different data have been reported by Gelatt and MacKay (2004), who presented the results of a retrospective study of a 39-year period. According to the results of t...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Combined iridencleisis and posterior sclerectomy in surgical treatment of glaucoma secondary to uveitis in a dog: a case report

Lew¹,

Lew²

2009

Vet. Med. - Czech

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“…In later modifications only the peripheral iris was prolapsed and incarcerated in the sclerotomy [ 11 ], leaving the pupil intact, but with a lower success rate [ 12 ] since aqueous flow could be trapped in the fold of the iris. To avoid this also the iris root was ruptured while pulling the iris to one side of the sclerotomy, referred to as the lobe-like iridencleisis [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Iris from Iridectomy Used as Spacer underneath the Scleral Flap: The Iridenflip Trabeculectomy Technique

Groot

Aerts

Kiekens

et al. 2015

Journal of Ophthalmology

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Purpose. We describe a modified trabeculectomy technique in which the iris is used to prevent fibrosis of the scleral flap. Material and Methods. A retrospective case series of patients with medically uncontrolled open angle glaucoma underwent trabeculectomy. Instead of performing a classical iridectomy, the iris was used as spacer underneath the scleral flap. Postoperative management was identical to classical trabeculectomy, with suture removal and needling if necessary. Five of the patients underwent simultaneous phacoemulsification through a separate temporal corneal incision. Patients should have two-year follow-up. Results. Data of ten patients were analysed, two had a previous failed trabeculectomy, two had LTP, and one had a corneal transplantation. In 3 patients MMC 0,1 mg/mL was used. After one and two years mean IOP was, respectively, 13,1 and 12,1 mmHg. IOP ≤ 16 mmHg was reached in 90% of patients without pressure lowering medication. No major complications were seen; no abnormal inflammatory reaction and no deformation or dislocation of the pupil occurred. Conclusion. By using the iris from the iridectomy as spacer under the scleral flap, fibrosis of the scleral flap is no longer possible. This iridenflip trabeculectomy technique gives an excellent complete success rate (IOP ≤ 16 mmHg) of 90%. A larger study is currently being done.

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Operationen, die einen neuen Abfluß herstellen

Leydhecker¹

1973

Glaukom

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Evaluation of modified techniques of iridencleisis.

Cited by 4 publications

References 9 publications

Combined iridencleisis and posterior sclerectomy in surgical treatment of glaucoma secondary to uveitis in a dog: a case report

Combined iridencleisis and posterior sclerectomy in surgical treatment of glaucoma secondary to uveitis in a dog: a case report

Iris from Iridectomy Used as Spacer underneath the Scleral Flap: The Iridenflip Trabeculectomy Technique

Operationen, die einen neuen Abfluß herstellen

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