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Ciliary surgery for glaucoma
Transactions of the Ophthalmological Societies of the United Kingdom
|January 1, 1986
Summary
Ciliary body excision effectively treated intractable glaucoma in 64 eyes, with nearly 80% achieving satisfactory intraocular pressure post-surgery. This surgical approach minimized complications in previously operated eyes.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Intractable glaucoma often requires advanced surgical intervention.
- Secondary angle-closure glaucoma with aphakia presents unique treatment challenges.
- Previous glaucoma surgeries may not achieve sustained intraocular pressure control.
Purpose of the Study:
- To evaluate the efficacy and safety of ciliary body excision for intractable glaucoma.
- To analyze indications, complications, and outcomes of this surgical procedure.
- To assess the long-term effectiveness in complex glaucoma cases.
Main Methods:
- Partial excision of the pars plicata of the ciliary body performed on 64 eyes (75 operations) between 1975 and 1985.
- Utilized a Fleiringa-ring, paracentesis, and extensive cauterization to minimize intraoperative complications.
- Employed double scleral wound closure to reduce postoperative complications like scleral wound dehiscence.
Main Results:
- Nearly 80% of cases achieved satisfactory postoperative intraocular pressure.
- Intraoperative complications such as vitreous loss and hemorrhage were minimized.
- Postoperative scleral wound dehiscence was reduced through double scleral closure.
Conclusions:
- Ciliary body excision is a viable surgical option for managing intractable glaucoma, particularly in complex cases with prior surgical failures.
- The described surgical techniques effectively reduce both intraoperative and postoperative complications.
- Satisfactory long-term intraocular pressure control can be achieved in a significant majority of patients.