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Minimally Invasive Glaucoma Surgery
Ashok Garg, Tanuj Dada, Jerome Jean – Phillippe Bovet, Roberto G Carassa
CHAPTER ONE:
Minimally Invasive Glaucoma Surgery (MIGS)—A New Approach
INTRODUCTION
CLASSIFICATION
Surgical Based MIGS
Viscocanalostomy
Deep Sclerectomy
Milling Trabeculoplasty
Sclerothalamotomy (STT)
Deep Sclerocanalostomy (DSC)
Laser-Based MIGS
Excimer Laser Trabeculotomy
Titanium Sapphire Laser Trabeculoplasty
Non-penetrating Glaucoma Surgery with the CO2 Laser
Selective Laser Trabeculoplasty
Scleral Expansion Bridge (SEB)
CHAPTER TWO:
YAG Laser Iridotomy
INTRODUCTION
INDICATIONS
CONTRAINDICATIONS
ABRAHAM CONTACT LENS
PREOPERATIVE PREPARATION
THE SELECTION OF IRIDOTOMY SITE
LASERS USED
Nd: YAG Laser Iridotomy
Argon and YAG Laser Combined
POST-LASER TREATMENT
COMPLICATIONS
Common Complications
Transient Rise of IOP
Iridocyclitis
Other Communications
Hyphema
Closure of Iridotomy
Cataract Formation
Rare Complications
Retinal Burns
Malignant Glaucoma
Endothelial Cell Loss
Posterior Synechia
Failure of Iridotomy
CHAPTER THREE:
Laser Sclerotomy
INTRODUCTION
HISTORY
ND: YAG LASER
LASER SCLEROTOMY WITH ND: YAG – INSTRUMENTATION
SURGICAL TECHNIQUE
Paracentesis
Clear Corneal Incision
Laser Sclerotomy
Peripheral Iridectomy
Closure of Incision
Laser Phakonit and IOL Implantation
Phakic Laser Sclerotomy
Laser Sclerotomy in Pseudophakia and Aphakia
CHAPTER FOUR:
Laser Trabeculoplasty
INTRODUCTION
ARGON LASER TRABECULOPLASTY
Indications
The Technique
How Does ALT help?
Complications
Transient Rise of IOP
Transient Mild Iritis
Other Complications
Results
Factors Influencing the Response of ALT
Good Responders
Fair Responders
Poor Responders
Repeat Trabeculoplasty
Comparison of Selective Laser Trabeculoplasty and ALT
CHAPTER FIVE:
Laser Treatment in Glaucomas
LASER PRINCIPLE AND INTRODUCTION
LASER IRIDOTOMY
LASER TRABECULOPLASTY
LASER PERIPHERAL IRIDOPLASTY
CYCLOCOAGULATION WITH YAG AND DIODE LASER
LASER TREATMENTS AFTER FILTERING SURGERY
SCLEROSTOMIES
CHAPETR SIX:
Miscellaneous Laser Applications
NEODYMIUM YAG LASER IRIDOLENTICULAR SYNECHIOLYSIS
Pre-laser Workup
Technique of Laser Therapy
Clinical Results
Modified Technique for Nd: YAG Laser Iridolenticular Synechiolysis
LASER SUTUROLYSIS
Technique
LASER-ASSISTED BLEB REMODELING
Technique
Nd:YAG GONIOPUNcTURE
Complications
ERBIUM-YAG LASER-ASSISTED DEEP SCLERECTOMY
Technique
ANTERIOR HYALOIDOTOMY
LYSIS OF VITREOUS STRAND IN THE CATARACT WOUND
CHAPETR SEVEN:
Trabecular Meshwork Ablation as an Alternative to Invasive Glaucoma Surgery
INTRODUCTION
ERBIUM-YAG GONIOTOMY
EXCIMER-LASER-TRABECULOTOMY (ELT)
Background
Surgical Procedure
Study Results
CONCLUSION
CHAPETR EIGHT:
Sclerothalamotomy Ab Interno a Minimally Invasive Glaucomo Surgery
INTRODUCTION
PATIENTS AND METHODS
HIGH-FREQUENCY DIATHERMIC PROBE
SURGICAL PROCEDURE
EVALUATION OF THE RESULTS
Results
DISCUSSION
CHAPETR NINE:
Laser Surgical Treatment of Glaucoma by Excimer Laser with 193 nm Wavelength
INTRODUCTION
BACKGROUND AND OBJECTIVE
PATIENTS AND METHODS
SURGICAL TECHNIQUE
RESULTS AND DISCUSSION
CONCLUSION
CHAPTER TEN:
Topical Anesthetic and the subconjunctival Bubble in Glaucoma and Combined Operations
OBJECTIVE AND INTRODUCTION
HISTORICAL BACKGROUND
ANATOMICAL REVIEW OF CORNEAL INNERVATION
PHARMACOLOGY
DESCRIPTION OF TOPICAL ANESTHESIA TECHNIQUES
Cataract
Glaucoma
Combined Cataract/Glaucoma
COMPLEMENTARY SEDATION USING INTRAVENOUS INJECTION
PREPARATION OF THE PATIENT
Preoperative Preparation
Preparation during the Operation
Postoperative Care and Patient's Home Return
CONCLUSION: ENVIRONMENT UNDER WHICH THE OPERATION TAKES PLACE
CHAPTER ELEVEN:
Cyclophotocoagulation
INTRODUCTION
INDICATIONS OF CYCLODESTRUCTIVE PROCEDURES
MECHANISM OF ACTION
Decreased Aqueous Production
Increased Aqueous Outflow
CYCLOPHOTOCOAGULATION
Trans-scleral Cyclophotocoagulation with the Nd: YAG Laser
Results of Clinical Trials
Trans-scleral Cyclophotocoagulation with Semiconductor Diode Laser
Results of Clinical Trials
Krypton Laser Cyclophotocoagulation
Results of Clinical Trials
Endoscopic Cyclophotocoagulation (ECP)
Results of Clinical Trials
Transvitreal Cyclophotocoagulation
Transpupillary Cyclophotocoagulation
POSTOPERATIVE MANAGEMENT
COMPLICATIONS
Conclusions
CHAPTER TWELVE:
Milling Trabeculoplasty: A New Technique for Non-penetrating Glaucoma Surgery
INTRODUCTION
INDICATIONS
PATIENT PREPARATION
Preoperative Examination
Preoperative Medications
Anesthesia
MILLING SURGICAL PROCEDURE
Instruments
Surgical Steps
POSTOPERATIVE FOLLOW-UP
Treatment
Follow-up
RESULTS
Group I (Milling Procedure)
Group II (Milling Procedure combined with Phaco)
DISCUSSION
CONCLUSION
CHAPTER THIRTEEN:
Deep Sclerectomy with T-flux Implant with “Outside In” Drainage
INTRODUCTION
NATURE'S DRAINAGE CHANNELS
ENSURE SURGICAL SUCCESS
HISTORY OF THE PROCEDURE
DEEP SCLERECTOMY WITH T-FLUX IMPLANT
THE FLIP SIDE
DEEP SCLERECTOMY WITH T-FLUX IMPLANT WITH SUPRA-CHOROIDAL DRAINAGE
THE SURGICAL PROCEDURE
CONCLUSION
CHAPTER FOURTEEN:
Viscocanalostomy
INTRODUCTION
MECHANISM OF ACTION
SURGICAL TECHNIQUE
Conjunctival Flap Dissection
Outer Scleral Flap Dissection
Inner Scleral Flap Dissection
Paracentesis
Cannulation of Schlemm's Canal (Figs 14.2 and 14.3)
Creation of Descemet's Window
Inner Scleral Flap Excision
Outer Scleral Flap Suture
Closure of the Conjunctiva
INDICATIONS
RESULTS
Retrospective Studies
Prospective Studies
Randomized Controlled Studies
CONCLUSIONS
CHAPTER FIFTEEN:
Pneumatic Trabeculoplasty – A Noninvasive Glaucoma Treatment
INTRODUCTION
Clinical Trials
Adverse Events
Considerations for Reduction in Anti-glaucoma Medication
The Substantive Equivalence of PNT and ALT
CONCLUSION
CHAPTER SIXTEEN:
Selective Laser Trabeculoplasty
INTRODUCTION
CHAPTER SEVENTEEN:
Customized Laser Assisted Filtration Surgery (CLAFS) Using a Solid-State UV Laser
INTRODUCTION
NPDS – AN EVOLUTIONARY TECHNIQUE
LASER-ASSISTED TECHNIQUES FOR THE FUTURE
CUSTOMIZED LASER ASSISTED FILTRATION SURGERY (CLAFS) WITH THE PR-270
CHAPTER EIGHTEEN:
Non-penetrating Filtration Surgery with the CO2 Laser
INTRODUCTION
PRECLINICAL STUDIES
CLINICAL STUDIES
Summary
Video
CHAPTER NINETEEN:
Open Angle Filter Surgery for Glaucoma: Deep Sclerocanalostomy (DSC) – A New Technique
HISTORY
ANATOMOPHYSIOLOGY
New Techniques
SURGICAL TECHNIQUE IN OUTPATIENT SURGERY17
Local Anesthetic5
Choices for Dissection
CONJUNCTIVAL SHUTTER WITH LIMB
Stages
1st Scleral Flap
2nd Scleral Flap
Removal of the Second Flap
Cut up the Scleral Flap in Half
Canalostomy
Implant/Mitomycine C
POSTOPERATIVE TREATMENT
POSTOPERATIVE CHECKUPS
PEROPERATIVE COMPLICATIONS
CHAPTER TWENTY:
Bimanual Microphaco and Deep Sclerocanalostomy (BMP & DSC) — A New Technique
INTRODUCTION/INDICATIONS
SURGICAL TECHNIQUE
1st Stage: Glaucoma
1st Scleral Flap
2nd Stage: Cataract
Bimanual Microphaco 19G
Capsulorhexis
Flip and Chop Phacoemulsification
Lens Implantation
3rd Stage Glaucoma
2nd Scleral Flap
POSTOPERATIVE TREATMENT
POSTOPERATIVE CHECK-UPS
COMPLICATIONS
Complications During the Operation
Postoperative Complications
CHAPTER TWENTY ONE:
Very Deep Sclerectomy—or How to Increase Uveoscleral Outflow
INTRODUCTION
GENERALITIES
SURGICAL TECHNIQUE
PRELIMINARY RESULTS
POSTOPERATIVE MANAGEMENT
CONCLUSION
CHAPTER TWENTY TWO:
G-Probe as Primary Glaucoma Procedure in Cases of Coexisting POAG and Cataract
INTRODUCTION
MATERIALS AND METHODS
CLASSIFICATION
RESULTS
CONCLUSION
CHAPTER TWENTY THREE:
Combined Phacoemulsification and Deep Sclerectomy with T-Flux®
INTRODUCTION
SURGICAL TECHNIQUE
PERSONAL STUDY
CONCLUSIONS
CHAPTER TWENTY FOUR:
Glaucoma Surgery Techniques with the Fugo Blade®
INTRODUCTION
FUGO BLADE®
THE IMPORTANCE OF CONJUNCTIVAL LYMPHATICS IN GLAUCOMA SURGERY
GLAUCOMA SURGERY TECHNIQUES WITH THE FUGO BLADE®
Transciliary Filtration (Singh Filtration)17
Transconjunctival Transciliary Filtration (Singh TC-TCF)25
Microtrack Filtration (Singh MTF)27
Non-perforating Filtration (NPF)
Open Non-perforating Filtration (Singh NPF)
NPF Under a Limbus Based Sclerocorneal Flap
NPF Under a Fornix Based Corneoscleral Flap (Singh)
FOLLOW-UP
CONCLUSION
INDEX
TOC
Index
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