Results of surgical treatment of glaucoma using sinustrabeculectomy modified for drainage of anterior chamber and suprachoroidal space by autosclera

Фролов, М.А.; Ryabey, A.V.; Frolov, A.M.

doi:10.17116/oftalma202013603146

Cited by 1 publication

(2 citation statements)

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“…The detachment of the ciliary body from the scleral spur is traumatic, and cyclodialysis clefts have the tendency to close down due to the associated inflammation. Various modifications of the cyclodialysis procedure with implantations of different kinds of drainage devices and implants have been proposed in the research and are being used with variable success [ 14 , 16 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. CyPASS, a device inserted in the cyclodialysis tunnel ab interno [ 54 ], showed promising results in terms of decreasing IOP; however, the long-term observations demonstrated a progressive loss of endothelial cells.…”

Section: Discussionmentioning

confidence: 99%

“…Various surgical techniques and modifications of the existing techniques in the field have been proposed in the literature, and different devices have been used in clinical practice, to date, to enhance AH outflow via this pathway. However, the surgical outcomes of these techniques and devices are unpredictable [ 11 , 12 , 13 , 14 , 15 , 16 ]. In most of these techniques, performing surgical cyclodialysis is mandatory.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics

Kumar,

Bezzabotnov,

Rustamova

et al. 2023

Vision

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A surgical technique was developed to enhance aqueous humor (AH) flow through the non-trabecular outflow pathway by rerouting it from the anterior chamber (AC) to the suprachoroidal space (SCS) without detaching the ciliary body from the scleral spur. Medium- and long-term surgical outcomes were retrospectively analyzed in a case series of 58 glaucoma patients. At 6, 12, and 24 months, the mean IOP decreased from 27.8 ± 8.3 to 14.9 ± 5.0 mmHg, median 15.0 (25th percentile (p25)13.0; 75th percentile (p75) 18.0) and 15.2 ± 3.3 mmHg, and hypotensive medication use reduced from a median (p25; p75) of 3 (2; 3) to 0 (0; 2), 0 (0; 2), and 0 (0; 1.5), respectively. Intra- and postoperative complications were few and manageable. Following surgery, no bleb formation occurred in any of the cases (as confirmed by optical coherence tomography). Conjunctival lymphatic vessels (CLVs) developed in 50% of eyes (29/58). Clinically, they developed directly from sclera and had no connection to the surgical site. Analysis further showed that the development of CLVs and their longer visibility period had poor prognostic value for IOP control. If the fluid flow from the SCS to CLVs was resistance-free, no CLV development was evident. However, if any resistance existed in the flow, the fluid accumulated in lymphatics, resulting in their engorgement. The proposed technique was safe and effective in decreasing IOP in glaucoma patients by enhancing AH flow from the SCS to CLVs via connecting intrascleral microchannels.

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