Outpatient Surgery Magazine

Calm & Cool in a MH Crisis - Subscribe to Outpatient Surgery Magazine - March 2018

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/954375

Contents of this Issue

Navigation

Page 45 of 124

Trabeculectomy improvements When many of us think about glaucoma sur- gery, we think about trabeculectomy. Until about 15 years ago, that was our bread- and-butter approach. Glaucoma occurs because the channels that allow aqueous to flow out of the eye become less efficient. This procedure, like most, is aimed at correcting that problem. Trabeculectomy involves opening the conjunctiva, dissecting the sclera and then making an incision under a scleral flap, into the anteri- or chamber and removing a piece of the peripheral iris to allow fluid to flow out. Our "Gold Standard" procedure is about as elegant as drilling a hole in the side of a bathtub and placing a bucket next to it to collect the water. When it works, it can work well, but sometimes pressure drops too much, resulting in a potentially devastating condition called hypotony. The conjunctival bleb can scar down, stopping outflow. Also, because there's an open communication, these patients are at lifelong risk for endophthalmitis. Trab-eculectomy patients also take as long as 3 months to heal. In the early 2000s, Optonol (later bought by Alcon) introduced the Ex- Press, a tiny stainless steel shunt that made trabs somewhat better. Instead of relying on a passageway made of tissue, the Ex-Press allows 4 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M a r c h 2 0 1 7 • ALCON'S CYPASS stent uses a different outflow pathway than the iStent, let- ting you implant both in a single eye. Matt Poe-www.OphthalmicPhotography.Info

Articles in this issue

Links on this page

Archives of this issue

view archives of Outpatient Surgery Magazine - Calm & Cool in a MH Crisis - Subscribe to Outpatient Surgery Magazine - March 2018