1 / 17

My Deep Sclerectomy is starting to fail.

My Deep Sclerectomy is starting to fail. Jordi Loscos Arenas MD, PhD Hospital Universitari Germans Trias i Pujol Barcelona. Failure location. _ Ab externo: Slit lamp _ Ab interno: Gonioscopy _ Surgical area : AS-OCT. Ab externo failure. _ Subconjuntival filtration decreased.

frahm
Download Presentation

My Deep Sclerectomy is starting to fail.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. My Deep Sclerectomy is starting to fail. Jordi Loscos Arenas MD, PhD Hospital Universitari Germans Trias i Pujol Barcelona

  2. Failurelocation _ Ab externo: Slitlamp _ Ab interno: Gonioscopy _ Surgicalarea: AS-OCT

  3. Ab externo failure _ Subconjuntivalfiltrationdecreased Non increased IOP _ Increase anti-inflamatory topical therapy _ Subconjunctival Dexamethasone _ Subconjunctival Bevacizumab _ Conjunctivalmycrocystsabsence _ Increasedvascularity _ Sealedsclerallips _ Flatteningbleb Increased IOP _ Needling MMC Always consider Goniopuncture !!!

  4. Ab externo failure Needling with MMC Subconjunctival Bevacizumab

  5. Needling

  6. Ab interno failure Increased IOP _ Appositional contact between the iris and trabecular meshwork _ Peripheral anterior synechia _ TDM fibrosis _ Iris incarceration _ Goniopuncture _ Iridoplasty _ Reopening primary surgical site _ Another surgery

  7. Iridoplasty _ Spot 500 µ _ 150-200 ms _ 150-300 mW

  8. Goniopuncture _ Notbefore 2 weeks _ NdYag: 2-4 mJ _ Avoidhigh IOP _ TDM transparency _ Pilocarpine _ Iridoplasty Dr. M Javier González,Vigo

  9. Goniopuncture _ V-2000 _ V-Clip Always consider Iridoplasty !!!

  10. Iridoplasty & Goniopuncture 1_ Pilocarpine 2_ Argon Laser 3_ NdYAG

  11. Iridoplasty & Goniopuncture Nitin Anand MD Ophthalmologist Winfield Hospital,UK

  12. Iridoplasty & Goniopuncture Synechia 1_ Pilocarpine 2_ Argon Laser 3_ NdYAG Incarceration

  13. Surgicalarea: AS-OCT _ Intrascleral bleeding _ Intrascleral bridges

  14. Surgicalarea: AS-OCT _ uveal prolapse

  15. Surgicalarea: AS-OCT Transparent TDM Reopening primary surgical site Same Site Technique Another surgery

  16. SameSiteTechnique

  17. Moltes gràcies http://drloscosoftalmologia.com/

More Related