- Glaucoma filtration surgery is indicated when other available treatment
modalities such as medications and laser therapies have failed to
control the intraocular pressure level or to prevent against progression
of the disease (e.g. visual field loss or optic disc cupping).
- The use of adjunctive antiproliferatives (5-fluorouracil and mitomycin-C)
to prevent subconjunctival tissue scarring after glaucoma filtration
surgery has increased the successful control of intraocular pressure
in eyes at a high risk of surgical failure (e.g. neovascular glaucoma,
uveitic glaucoma, previous failed bleb, younger age patient).
- Characteristics of antiproliferative-associated filtering blebs:
- Pale
- Avascular (ischemic),
- Localized cystic bleb with surrounding zone of increased vascularity
- Post-operative assessments to ascertain filtration bleb functionality
and to detect potential complications include vision and intraocular
pressure, wound leak (Seidel test), anterior chamber depth, corneal
clarity and epithelium integrity, and presence of suprachoroidal hemorrhage
or choroidal effusion detachment.
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