Secondary traumatic aniridic glaucoma: pathogenesis and treatment modalities
DOI: 10.32364/2311-7729-2021-21-4-235-240
N.P. Sobolev, V.V. Teplovodskaya, M.A. Soboleva, E.P. Sudakova
S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
Ocular hypertension resulting from eye injuries occurs in 0.78–6.2%. Penetrating eye injuries rank first (22.5%), and blunt eye traumas rank second (7.65%). This paper addresses recent data on various surgical techniques for secondary traumatic aniridic glaucoma, their pros, and cons. When selecting a surgical technique, a differentiated approach should be followed depending on traumatic lesions of the anterior segment and hydrodynamics. Sometimes, implantation of a prosthetic iris device with an intraocular lens (to close iris defect and restore the diaphragmic function of the iris) triggers the onset of secondary glaucoma after iris injury. In uncontrolled intraocular pressure in the early postoperative period and preserved at least one-third of the iris, a non-penetrating deep sclerectomy can be performed. In extensive tissue damage (less than one-third of the iris is preserved), implantation of glaucoma drainage devices is a pathogenetically oriented strategy.
Keywords: traumatic glaucoma, aniridia, secondary glaucoma, glaucoma surgery, prosthetic iris device with an intraocular lens.
For citation: Sobolev N.P., Teplovodskaya V.V., Soboleva M.A., Sudakova E.P. Secondary traumatic aniridic glaucoma: pathogenesis and treatment modalities. Russian Journal of Clinical Ophthalmology. 2021;21(4):235–240 (in Russ.). DOI: 10.32364/2311-7729-2021-21-4-235-240.
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24. Heidenkummer H.-P., Mangouritsas G., Kampik A. Klinische Anwendung und Ergebnisse der transskleralen Nd-YAG-Zyklophotokoagulation bei therapierefraktärem Glaukom. Klin Monbl Augenheilkd. 1991;198(3):174–180. DOI: 10.1055/s-2008-1045947.
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27. Sidorova A.V., Khodzhaev N.S., Starostina A.V. et al. Micropulse technology in combination with drainage surgery for refractory glaucoma. Sovremennye tehnologii v oftal’mologii. 2020;4:149–150 (in Russ.). DOI: 10.25276/2312-4911-2020-4-149-150.
28. Sobolev N.P., Sidorova A.V., Opletina A.V., Veselkova M.P. Patent RF RU 2588396 C1 dated 06/27/2016. A method for combined surgical treatment of secondary glaucoma in post-traumatic aniridia. (Electronic resource.) URL: https://patentscope.wipo.int/search/ru/detail.jsf?docId=RU174260063 (access date: 03.10.2021) (in Russ.).
29. Hodzhaev N.S., Sidorova A.V., Baeva A.V., Smirnova E.A. Transscleral laser treatment of end-stage glaucoma in the micropulse mode: a pilot study. Novosti glaukomy. 2019;1(49):3–5 (in Russ.).
30. Sanchez F.G., Lerner F., Sampaolesi J. et al. Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation in Glaucoma. Archivos de la Sociedad Espanola de Oftalmologia (English version.) 2018;93(12):573–579. DOI: 10.1016/j.oftale.2018.08.006.
31. Sidorova A.V., Khodzhaev N.S., Eliseeva M.A., Starostina A.V. Drainage surgery for refractory glaucoma combined with micropulse cyclophotocoagulation. Saratov Journal of Medical Scientific Research. 2020;16(1):273–276 (in Russ.).
2. Egorov E.A. Glaucoma National Guidelines for Practicing Physician. M.: Ophatalmology; 2019 (in Russ.). DOI: 10.33029/9704-5442-8-gla-2020-1-384.
3. Schlote T., Rohrbach M. Traumatische Glaukome — Eine Übersicht. Klinische Monatsblätter Für Augenheilkunde. 2005;222(10):772–782. DOI: 10.1055/s-2005-858458.
4. Sobolev N.P., Ioshin I.E., Shatskikh A.V., Novikov S.V. Clinical morphological charactristics of iris-ciliary zone in secondary posttraumatic aniridic glaucoma. Fyodorov Journal of Ophthalmic Surgery. 2015;4:17–21 (in Russ.).
5. Stepanov A.V. Surgery for post-traumatic glaucoma: Guidelines. M.; 1988 (in Russ.).
6. Gundorova R.A., Stepanov A.V. Pathogenetic classification of post-traumatic glaucoma. Oftalmohirurgija. 1993;2:27–32 (in Russ.).
7. Pozdeeva N.A., Pashtaev N.P. Artificial iridocular lens diaphragm in the surgical treatment of aniridia. Cheboksary; 2012 (in Russ.). DOI: 10.25276/9785990357716.
8. Pozdeeva N.A., Pashtaev N.P., Voskresenskaya A.A., Frolychev I.A. Medical rehabilitation of patients with congenital aniridia. Prakticheskaya meditcina. 2015;2–1(87):16–25 (in Russ.).
9. Prokof’eva M.I. Modern surgical approaches to the treatment of refractory glaucoma (literature review). RMZh. Klinicheskaja oftal’mologija. 2010;11(3):104–108 (In Russ.).
10. Takhchidi Ch.P., Cheglakov V.Yu. Refractory glaucoma drainage devices. Review. Refrakcionnaja hirurgija i oftal’mologija. 2009;9(3):11–16 (in Russ.).
11. Pozdeyeva N.A., Frolychev I.A., Pashtaev N.P. Vitreoretinal surgery in posttraumatic aniridia. Ophtalmosurgery. 2012;3:42–47 (in Russ.).
12. Gorbunova N.Ju. Surgical treatment of patients with refractory glaucoma based on the use of perforated explant drainage: thesis. M.; 2008 (in Russ.).
13. Tedeyeva N.R. Uveoscleral drainage in post-traumatic glaucoma surgery: thesis.. M.; 2016 (in Russ.).
14. Ivanov D.I. Diagnostic system and pathogenetically oriented methods of treatment of angle-closure glaucoma with organic blockade of the anterior chamber angle Rossijskaja oftal’mologija online № 5. 2012;3:14–17 (in Russ.).
15. Ioshin I.Je., Kalinnikov Ju.Ju., Hachatrjan G.T. The use of Ahmed valve drainage in the treatment of glaucoma in patients with baseline high visual function.. Oftal’mohirurgija. 2011;2:47 (in Russ.).
16. Yadgarov A., Liu D., Crane E.S., Khouri A.S. Surgical Outcomes of Ahmed or Baerveldt Tube Shunt Implantation for medically Uncontrolled Traumatic Glaucoma. Curr Glaucoma Pract. 2017;11(1):16–21. DOI: 10.5005/jp-journals-10008-1215.
17. Pozdeeva N.A., Gorbunova N.Ju., Pashtaev N.P. Efficacy of Valve Drainage Devices in Secondary Glaucoma in Patients with Artificial Irido-lenticular Diaphragm. Vestnik oftal’mologii. 2011;127(4):41–45 (in Russ.).
18. Almousa R., Lake D.B. Intraocular pressure control with Ahmed glaucoma drainage device in patients with cicatricial ocular surface disease-associated or aniridia-related glaucoma. International ophthalmology. 2014;34(4):753–760. DOI: 10.1007/s10792-013-9868-6.
19. Stepanov A.V., Gamzayeva U.S., Tedeyeva N.R., Lugovkina K.V. Subscleral implantation of biodegradable polylactide drainage in refractory posttraumatic glaucoma treatment. National Journal glaucoma. 2018;17(2):39–46 (in Russ.).
20. Stepanov A.V., Nisov A.V. The long-tearms results of ahmed glaucoma valve implantation at a posttraumatic glaucoma. Nacional’nyj zhurnal glaukoma. 2011;11(2):34–37 (in Russ.).
21. Stepanov A.V., Nisov A.V. Ahmed valve in the treatment of posttraumatic glaucoma in eyes with aniridia and aphakia Rossijskij oftal’mologicheskij zhurnal. 2011;4(3):61–63 (in Russ.).
22. Wiggins R.E. Jr., Tomey K.F. The results of glaucoma surgery in aniridia. Archives in ophthalmology. 1992;110(4):503–505. DOI: 10.1001/archopht.1992.01080160081036.
23. Markova A.A., Pashtaev N.P., Pozdeeva N.A. Surgical treatment of refractory post-traumatic glaucoma based on endoscopic cyclophotocoagulation. In: VIII All-Russian scientific conference of young scientists "Actual problems of ophthalmology". M.; 2013 (in Russ.).
24. Heidenkummer H.-P., Mangouritsas G., Kampik A. Klinische Anwendung und Ergebnisse der transskleralen Nd-YAG-Zyklophotokoagulation bei therapierefraktärem Glaukom. Klin Monbl Augenheilkd. 1991;198(3):174–180. DOI: 10.1055/s-2008-1045947.
25. Bloom P.A., Clement C.I., King A. et al. A comparison between tube surgery, ND: YAG laser and diode laser cyclophotocoagulation in the management of refractory glaucoma. Biomed Research International. 2013;1:11. DOI: 10.1155/2013/371951.
26. Kaplowitz K., Kuei A., Klenofsky B. et al. The use of endoscopic cyclophotocoagulation for moderate to advanced glaucoma. Acta Ophthalmology. 2015;93(5):395–401. DOI: 10.1111/aos.12529.
27. Sidorova A.V., Khodzhaev N.S., Starostina A.V. et al. Micropulse technology in combination with drainage surgery for refractory glaucoma. Sovremennye tehnologii v oftal’mologii. 2020;4:149–150 (in Russ.). DOI: 10.25276/2312-4911-2020-4-149-150.
28. Sobolev N.P., Sidorova A.V., Opletina A.V., Veselkova M.P. Patent RF RU 2588396 C1 dated 06/27/2016. A method for combined surgical treatment of secondary glaucoma in post-traumatic aniridia. (Electronic resource.) URL: https://patentscope.wipo.int/search/ru/detail.jsf?docId=RU174260063 (access date: 03.10.2021) (in Russ.).
29. Hodzhaev N.S., Sidorova A.V., Baeva A.V., Smirnova E.A. Transscleral laser treatment of end-stage glaucoma in the micropulse mode: a pilot study. Novosti glaukomy. 2019;1(49):3–5 (in Russ.).
30. Sanchez F.G., Lerner F., Sampaolesi J. et al. Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation in Glaucoma. Archivos de la Sociedad Espanola de Oftalmologia (English version.) 2018;93(12):573–579. DOI: 10.1016/j.oftale.2018.08.006.
31. Sidorova A.V., Khodzhaev N.S., Eliseeva M.A., Starostina A.V. Drainage surgery for refractory glaucoma combined with micropulse cyclophotocoagulation. Saratov Journal of Medical Scientific Research. 2020;16(1):273–276 (in Russ.).
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