[Fistulizing reoperations in open-angle glaucoma]

The authors analyze the results of repeated fistulization surgery (traditional trabeculectomy and that combined with resection of the episclera, and valvular trabeculectomy) in 40 patients (41 eyes) with primary open-angle glaucoma. A follow-up of 6 mos to 4 yrs has shown normalization of the ophthalmic tone in 90.2% of cases, in 65.8% of these this was achieved without drugs. Vision acuity remained unchanged or improved in 58.5% of cases, visual field was preserved or improved in 80.5% of patients. These results have lead the authors to a conclusion that a stable hypotensive effect can be achieved if repeated fistulization is performed outside the site of the primary intervention. If repeated trabeculectomy has to be performed at the site of the primary intervention, it is recommended to be combined with resection of the episclera, this improving the reliability of the hypotensive effect of surgery.