Endoscopic Goniosynechialysis for Acute Angle Closure Glaucoma Following Descemet's Stripping Automated Endothelial Keratoplasty

JOURNAL TITLE: Journal of Current Glaucoma Practice

Author
1. Sunil Shah
2. Pravin Pandey
3. Mrinal Rana
4. Imran Masood
ISSN
0974-0333
DOI
10.5005/jp-journals-10028-1250
Volume
12
Issue
2
Publishing Year
2018
Pages
4
Author Affiliations
    1. Birmingham and Midland Eye Centre, Birmingham, UK
    2. Sarvamangal Hospital, Ahmedabad, Gujarat, India
    1. Department of Ophthalmology, Peterborough City Hospital, North West Anglia Hospital NHS Trust, Bretton Gate, Peterborough, UK
    1. Department of Ophthalmology, Birmingham and Midland Eye Centre, UK
    1. Department of Ophthalmology, Birmingham and Midland Eye Centre, UK
  • Article keywords
    Cohort study, Educational training, Glaucoma, Resident versus attending, Tube shunt surgery

    Abstract

    We describe a new modified technique to release the peripheral iridocorneal adhesions that formed after Descemet stripping automated endothelial keratoplasty. The usual technique of goniosynechialysis was modified and performed using endoscopic fiber-optic light and camera probe to aid visualization of the adherent iris tissue and carry out uneventful 270 degrees release of adhesions. The iris tissue was gently pulled away using micro forceps. The modified technique was conceptualized, as the view from the cornea was very poor due to recent lamellar surgery and corneal oedema secondary to poorly controlled intraocular pressure. The blocked trabecular meshwork system was successfully recanalized, which allowed an adequate control of intraocular pressure. The graft survived the insult and cornea gained complete clarity giving the patient the desired vision and improved quality of life.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved