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PubMed · 4058862

Laser and glaucoma: our experience.

A Reibaldi·M G Uva·G L Scuderi
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Abstract

The authors present some guidelines on laser therapy (Argon and/or Yag) application on the different types of glaucomatous pathology. These therapeutic guidelines are the result of a 3-year experience of constant laser therapy application on glaucoma. The case reports include 196 A-laser trabeculoplasties, 34 A-laser iridotomies, 158 Yag-laser iridotomies, 31 gonioplasties, plus numberless combined treatments (iridotomy-trabeculoplasty, gonio-trabeculoplasty, gonioplasty-ciliary body photocoagulation, and so on). The authors conclude by reaffirming the considerable reliability of these techniques, given a prolonged follow-up; they also advance some new therapeutic hypotheses on laser operation in glaucomas.

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GlaucomaGlaucoma, Open-AngleHumansIrisLaser TherapyMethodsTrabecular MeshworkJournal Article

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A Reibaldi, M G Uva, G L Scuderi. 1985. Laser and glaucoma: our experience.. https://doi.org/10.1159/000309560

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Do scleral flap dimensions influence reliability of intraocular pressure control in experimental trabeculectomy?

AIM: To compare the effect on intraocular pressure (IOP) of large vs small scleral flap size during trabeculectomy using adjustable sutures. METHODS: Trabeculectomy operations were performed on nine donor human eyes connected to a constant flow infusion with real-time IOP monitoring. Large scleral flaps (4 x 4 mm, 16 mm(2), n=12) or small scleral flaps (3 x 2 mm, 6 mm(2), n=9) were constructed over 0.76 mm(2) sclerostomies. For each procedure, equilibrium IOP was measured following tight closure with two four-throw adjustable 10-0 nylon sutures. RESULTS: Five scleral flaps were thin or poorly constructed; four of these were in the initial seven procedures, implying learning effect. These had a mean absolute IOP of 7.6 mmHg (range 2.7-12.4 mmHg) and mean relative IOP of 28.3% of baseline (range 10-45.8%) after closure. In the remaining 16 good quality procedures, mean IOP was 1.3 mmHg (range 0-3.4 mmHg) after sclerostomy, confirming minimal outflow resistance before closure. Following flap closure mean IOP was 20 mmHg (SD 4.4, range 15.5-29.3 mmHg) for large (n=8), and 18.7 mmHg (SD 3.6, 15.9-25.8 mmHg) for small (n=8) flaps (unpaired t-test, P=0.26). Mean IOP (% baseline) was 71.6% (SD 8.4, range 60.6-86.6%) and 66% (SD=12.7, 46.8-86.6%) for large and small flap groups, respectively (unpaired t-test, P=0.2). CONCLUSIONS: Well-constructed scleral flaps of both sizes were able to support an average IOP at least two-thirds of baseline, and both had similar absolute IOP levels. Errors in flap construction resulted in loss of IOP control. Smaller flap size does not appear to compromise control of early postoperative IOP using adjustable sutures.

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