Retained lens fragment and subluxed IOL chafing induced post-op glaucoma

Retained lens fragment and subluxed IOL chafing induced post-op glaucoma

Patient presents 2 weeks following cataract surgery with retained lens fragments, iris chafing from subluxed IOL, broken bag, IOP of 51 and has had lens fragments supposedly removed already along with multiple paracenteses to attempt to bring the IOP down (along with being placed on multiple glaucoma meds.) Case is discussed and the surgery I performed is presented.

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Glaucoma risk factors: treat or not & how best to treat

Glaucoma risk factors: treat or not & how best to treat

Steven Mansberger from Portland talked about risk factors for glaucoma. We have come a long way from just educated guessing where our past success or failure influences our next treatment decision to the point of identifying risk factors for converting to glaucoma and even how best to treat patients. 

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Hypotony after trabeculectomy: don't stop anti-inflammatory drops & don't operate if post-op care inadequate.

Hypotony after trabeculectomy: don't stop anti-inflammatory drops & don't operate if post-op care inadequate.

The trabeculectomy involves creating a trap-door in the sclera underneath the upper lid. The goal of the follow-up care is basically to make sure that this trap door never heals properly so that it is leaking out a small amount of aqueous humour to the overlying conjunctival layer to lower the pressure inside the eye. It is vital that aggressive anti-inflammatory treatment be maintained in the early post-operative period to prevent proper healing. Unfortunately, sometimes my colleagues alter the originally planned post-operative regiment of aggressive steroid drops when they encounter too low a pressure or a shallow anterior chamber and jeopardize the chance of longterm success.

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Surgical repair of leaking trabeculectomy glaucoma filtering bleb

Surgical repair of leaking trabeculectomy glaucoma filtering bleb

A common late complication of trabeculectomy (glaucoma filtration surgery) is wound leak occurring many years after the surgery, especially when an antimetabolite such as Mitomycin-C was used at the time of the original surgery. This video shows my surgical technique for excising the non-viable leaky conjunctival tissue and advancing fresh tissue from the surrounding area.

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Glaucoma Surgery recent cases w/ follow-up: 1 day post-op surprise result, procedure specific consent, bleeding, and do you stop ASA?

robschertzer #Glaucoma #surgery 64 yo WM pigmentary glaucoma stable s/p SLT; Phaco/IOL today no complications. Pre-op challenge w/ Axial Length by U/S.

It turns out that the pre-operative challenge with the axial length discrepancy was nothing compared with the first post-operative day surprise; this one hurt but was a learning experience.

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Glaucoma Surgery round-up Oct 19, 2009 cases w/ 1wk post-op findings. Dealing w/ IOP spikes.

Glaucoma Surgery round-up Oct 19, 2009 cases w/ 1wk post-op findings. Dealing w/ IOP spikes.

Glaucoma surgery case round-up including a discussion on dealing with spikes in intraocular pressure (IOP) post-operatively

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