Final - Surgical Management Flashcards
Laser trabeculoplasty
- target
- how reduces IOP
- first 24 hours
- common complications
TM
Improving facility of outflow
On medications to prevent possible IOP spikes post-procedure
Iritis, periph ant synechiae
Laser trabeculoplasty
- 2 subtypes
- which scars (cannot repeat in same area)
- target of type that can be repeated
ALT, SLT
ALT
Melanin (SLT)
Laser trabeculoplasty
-best for what types of glaucoma (3)
POAG, exfoliation, pigmentary
Laser iridotomy
- brief description
- procedure of choice for
Hole in peripheral iris with argon or Nd:YAG
Angle-closure glaucoma
Laser iridotomy
-why/what it does/how it works (3)
Equalize pressure b/w AC and PC
Deepen AC
Open AC angle
Laser iridotomy
- how to check to make sure it’s all the way thru
- complications
Transillumination - check for defect
Transient spike, mild ant uveitis, hyphema, K damage, ct, retinal burn, blurring, closure of sx
Laser peripheral iridoplasty
- aka (2)
- when
Gonioplasty, peripheral iris retraction
When iridotomy fails
Laser peripheral iridoplasty
- how it works
- complications
Argon laser makes contraction burns to periph iris -> opens angle
Tightening of periph iris -> pulls it posteriorly from TM
IOP elevation, mild transient iritis
Laser pupilloplasty
- what
- when
- complications
Partially dilates pupil by applying contraction burns near pupillary portion of iris
Alternative method for pupillary block when cornea is cloudy
IOP rise, transient iritis
Iris sphincterotomy
- what
- how
Pupil is enlarged, reshaped, or repositioned
Make linear cut across iris, allowing intrinsic tension to spread the cut apart
Incisional iridectomy
- what
- when
- complications
Small section of periph iris is excised thru limbal incision
Acute angle closure
Hemorrhage, incomplete sx, lens injury, endopthalmitis
Trabeculectomy
- what
- complications
Creates opening in TM to est. direct communication b/w AC and Schlemm’s
False passage (if mis-ID Schlemm’s) -> cyclodialysis, possible hyphema
Trabeculectomy
-how it works
Probe inserted thru TM into Sclemm’s -> thermal ablation removes TM and internal wall of SC
Canaloplasty
- what
- when
Microcatheter/tube in Schlemm’s to enlarge drainage canal, relieving pressure inside the eye
Open-angle glauc, those at high risk for infection/bleeding, those who had complications with other eye, pts who wear CLS
Cyclodialysis
- what
- how it helps
Separate CB from SS via cyclo spatula -> creates direct communication b/w AC and suprachoroidal space
Incr uveoscleral outflow, reduces aqueous production (by changing ciliary anatomy)
