La Antigua Guatemala
La Antigua Guatemala
It is an important advance in glaucoma surgery and its indicated in the surgical treatment of open angle glaucoma. The procedure is done similarily as a trabeculectomy , starting with a disection of the conjuntiva at the limbus and its separation from the sclera , then the sclera is disected to form a flap until clear cornea is reached . A blue-gray line is identified ( trabecular meshwork ) and is perforated in its lowest area by a fine needle paralel to the iris plane.
The device is mounted on the injector and inserted into the eye by turning it to one side. Once inserted the device is turned to its original position and freed by pressing the injectors button.
Drainage of the acuous humor is observed . The scleral flap is placed back in its original position and sutured. Conjuntiva is placed back in its original position and sutured. A conjuntival bleb is formed.
The eye is patched with antibiotic ointment and oral antiinflamatory /analgesics are prescribed.
The patient will be examined by the doctor in 24 hrs.
Glaucoma is a disease that mainly affects the optic nerve, it is an optic neuropathy and high intraocular pressure is the most common cause.
Trabeculectomy drains the aqueous humor, a liquid formed inside the eye, helping to lower intraocular pressure to normal levels.
The procedure is done under local or general anesthesia (depending on the damage of the optic nerve) assisted by an anesthesiologist who monitors the patient during the procedure.
The procedure begins by placing a Nylon or Vicryl suture in clear cornea for traction purposes so an optimal exposure of the operating area is achieved.
A conjuntival disection is performed at the limbus and a wide dull disection under the conjuntiva is followed by a Tenons capsule disection and resection. A Mitomicin C soaked sponge is placed over the sclera, under the conjuntiva for 2-5 minutes and then is irrigated profusely. A half thickness triangular or rectangular scleral flap is dissected from the periphery to the clear corneal area. A resection of the trabecular meshwork is followed by a resection of the iris base in front of it, which allows the fluid to drain without blockage
The scleral flap is repositioned and sutured to the sclera besides it. Then the conjuntival flap is repositioned and sutured to the limbus. An ocular patch and ophthalmic ointment are placed on the operated eye for 24 hours and the next day the surgeon takes it off and starts topical treatment.
