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Ultrasound Cyclo Plasty in Eyes with Glaucoma

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Combined phacoemulsification with ExPRESS shunt in angle closure glaucoma.

¹LV Prasad Eye Institute, Patia, Bhubaneswar, Odisha, India.

Digital Journal of Ophthalmology : DJO

|June 23, 2016

Summary

This study shows ExPRESS shunt surgery can successfully treat advanced primary angle closure glaucoma, even with peripheral anterior synechiae. Proper placement ensures good visual outcomes and functioning shunts.

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Area of Science:

Ophthalmology
Glaucoma Research
Surgical Innovation

Background:

Primary angle closure glaucoma (PACG) presents unique challenges due to peripheral anterior synechiae (PAS).
Advanced PACG often requires surgical intervention when medical management fails.
Phacoemulsification combined with glaucoma drainage devices is a common surgical approach.

Observation:

A 60-year-old woman with advanced PACG and extensive PAS underwent combined phacoemulsification and ExPRESS shunt surgery.
The ExPRESS shunt was carefully placed to avoid areas of PAS during the procedure.
Postoperative follow-up demonstrated excellent visual acuity and controlled intraocular pressure.

Findings:

The combined surgery resulted in a visual acuity of 20/20 and an intraocular pressure of 13 mm Hg.
The ExPRESS shunt remained functional, with a well-formed bleb observed at the final follow-up.
Successful surgical outcome was achieved despite the presence of extensive PAS.

Implications:

The ExPRESS shunt is a viable option for managing complex cases of angle closure glaucoma.
Careful intraoperative technique, particularly shunt placement, is crucial for favorable outcomes in PACG.
This case highlights the potential for minimally invasive glaucoma surgery in challenging patient populations.