YAG-laser refistulization of internal fistula after trabeculectomy in children with post-uveal glaucoma

Катаргина, Л А; Arestova, N. N.; Денисова, Е. В.; Ibaid, B. N.A.

doi:10.25276/0235-4160-2019-1-57-61

Cited by 2 publications

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“…Полученные результаты были выше, чем у наблюдаемых детей в проведенных ранее исследованиях [1,12], что, очевидно, обусловлено применением антиметаболитов в ходе большинства операций. Кроме того, важную роль играет «активное» ведение послеоперационного периода с оценкой состояния внутренней фистулы и ранняя ИАГ лазерная рефистулизация при выявлении блокады фистулы [27] и динамический контроль за состоянием фильтрационной подушечки с помощью ультразвуковой биомикроскопии, а при параметрах, ассоциирующихся с риском декомпенсации ВГД [28], проведение антипролиферативных мероприятий.…”

Section: выводыunclassified

“…Факторами риска более низкой эффективности СТЭ, по данным разных авторов, анализировавших результаты преимущественно взрослых пациентов, являются: молодой возраст, повторное антиглаукомное вмешательство, воспалительный процесс на момент или после операции, гранулематозный/негранулематозный увеит, наличие рубцов конъюнктивы, неоваскуляризация переднего отрезка глаза, афакия или артифакия, высокое исходное ВГД, предшествующая лазерная трабекулопластика, длительное применение и количество местных гипотензивных препаратов, послеоперационные осложнения, факотрабекулэктомия или операция по поводу катаракты в ранние сроки после СТЭ [1,3,6,[14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”

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Factors of Excessive Proliferation after Trabeculectomy in Pediatric Uveitic Glaucoma

2021

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Objective: to study efficacy and factors of excessive proliferation after trabeculectomy (T) in pediatric uveitic glaucoma (UG).Patients and Methods. 102 children aged from 3 to 17.5 years (mean 124.5 ± 2.8 month) with uncontrolled on maximum topical hypotensive therapy open angle or combined (with peripheral anterior synechiae) form of UG underwent T (148 eyes, 180 operations). 76.1 % operations were performed with intraoperative 5-fluorouracil, 8.3 % — with mitomycin C, 6.1 % — with bioresorbable, 1.7 % — with collagen drainage, 7.8 % — without antimetabolites or drainages. Kaplan-Meier survival analysis was performed.Results. Overall absolute (without hypotensive therapy) success probabilities were 67 %, 46 %, 39 %, qualified success (with hypotensive therapy) — 93 %, 72 %, 54 % at 1, 3, 5 years after T respectively. Factors associated with failure were primary location of inflammation in anterior uvea, aphakic or pseudophakic eye, repeat T, bioresorbable drainage (vs. 5-fluorouracil), persistent inflammation after T. Age and uveitis activity at the moment of T, duration hypotensive therapy before primary T, postoperative complications (9.4 %), frequency of postoperative topical steroid had no significant influence on surgical success.Conclusion. T with intraoperative antimetabolites is effective, safe and nowadays may be recommended as first choice operation in pediatric open angle or combined UG.

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Section: выводыunclassified

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Factors of Excessive Proliferation after Trabeculectomy in Pediatric Uveitic Glaucoma

2021

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Clinical features of internal fistula obliteration after trabeculectomy in congenital glaucoma and the possibility of laser treatment

Arestova

Panova

Kireeva

2023

Russian Pediatric Ophthalmology

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AIM: This study aimed to evaluate the clinical features of internal fistula obliteration after trabeculectomy (TE) in children with congenital glaucoma and the possibility of laser treatment. MATERIAL AND METHODS: The study included 73 eyes of 56 children with congenital glaucoma who underwent TE between 3 months and 16 years. Yttrium aluminum garnet (YAG) laser refistulization was performed postoperatively because gonioscopy results revealed a complete or partial block of the internal fistula. In addition, a patented technique was utilized that combines the use of defocused and focused YAG laser radiation. RESULTS: The internal fistula was more often blocked by the iris root. YAG laser refistulization eliminated the block in 97.3% of cases, and in two cases, planar splices that had existed for 6 months could not be dissected. Laser removal of the internal fistula block in 97.3% of cases led to a normalization of the intraocular pressure (IOP) immediately after surgery and in 80.7% of cases in the subsequent year. Early refistulization (up to 3 months after TE) reduced the risk of IOP decompensation by 2.6 times by the annual follow-up. CONCLUSION: In children with congenital glaucoma, internal fistula obliteration (both complete and partial) by the iris root, iridotrabecular or iridocorneal contact, fusion, or pigment may occur at the earliest stages after TE, which is an indication of laser refistulization. When the internal fistula is overgrown after TE in children with congenital glaucoma, YAG laser refistulization allows restoring the lumen of the internal fistula in 97.3% of cases. Therefore, for timely detection and elimination of the blockade, gonioscopic monitoring of the internal fistula is necessary both at the earliest possible time and in the long term after TE.

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YAG-laser refistulization of internal fistula after trabeculectomy in children with post-uveal glaucoma

Cited by 2 publications

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Factors of Excessive Proliferation after Trabeculectomy in Pediatric Uveitic Glaucoma

Factors of Excessive Proliferation after Trabeculectomy in Pediatric Uveitic Glaucoma

Clinical features of internal fistula obliteration after trabeculectomy in congenital glaucoma and the possibility of laser treatment

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