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My Deep Sclerectomy is starting to fail.

Learn about the signs of deep sclerectomy failure and explore treatment strategies such as needling with MMC, subconjunctival bevacizumab, iridoplasty, and goniopuncture. Understand the importance of addressing increased IOP and anatomical changes to improve surgical outcomes.

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My Deep Sclerectomy is starting to fail.

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  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/

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