Surgical Modalities in Management of Recurrent Glaucoma

Abstract

The goal of filtering procedure is to lower the intra ocular pressure by crating a fistula which allows aqueous humour to drain from the anterior chamber. The aqueous flows directly or indirectly into the subconjunctival space, most of successful glaucoma filtering procedures are characterized by an elevation of the conjunctiva at the surgical site which is commonly referred to as a filtering bleb.

The use of intraoperative mitomycin C and 5-tluorouracil has greatly improved the results of filtration surgery in less favorable cases of high risk recurrent glaucoma. Implants are alternative surgical treatment in eyes with poor surgical prognosis. Reduction of pressure by modern implants is accomplished by shunting of aqueous through an open tube from the anterior chamber to an area of encapsulation around the explant.

Cyclodestuctive procedures including cyclophotocoagulation, cyclocryotherapy and cyclosclerotransthermy are important methods in lowering intraocular pressure by destruction to the ciliary body.