Surgery

Biography

Biography: Dida Kazakova

Abstract

Glaucoma has traditionally been classified as an ophthalmic disease associated with increased intraocular pressure and, accordingly, has been treated with antihypertensive drugs. However, retinal ganglion cells often continue to degenerate even when the pressure is reduced to normal level. Glaucoma a progressive optic neuropathy, is phenomenologically defined as a disease characterized by the loss of retinal ganglions cells and their axons, and tissue remodeling involving both the optic nerve head and the retina. In 1968, Cairns described the first successful trabeculectomy technique. Several techniques of the non-penetration filtering surgery based on sinusotomy published by Krasnov in 1968 have been described. Deep Sclerectomy is a operation with the patients with uncontrolled IOP (intraocular pressure) in open angle glaucoma. Postoperative IOP decreased significantly in the most of the patients. Some eyes had an  postoperative increase of IOP and additional procedures were performed, such a goniopuncture with Nd:Yag laser, or postoperative subconjunctival injections of mitomycin C. Non-penetration glaucoma surgery is the best treatment for open-angle glaucoma.NPGS targets the presumed site of pathology, namely the trabecular meshwork. Conventional glaucoma surgery in cases with high myopia carries a hiqh risk of complications because of the abnormal globe dimensions. Choroidal detachments and consequent shallow anteriors occur in 15% of trabeculectomies.NPGS appears to offer glaucoma patients a suffer outcome because of the gradual intraoperative IOP reduction. There are two areas of interest in the study of mechanisms involved in the efficiency and safety of non-penetrating surgeries: aqueous humor flow through the trabeculo-Descement's membrane; the created trabeculo-Descemet's window, allowing a progressive drop in IOP while at the same time offering enough resistance to prevent the immediate postoperatve complications. After aqueous humor passage through the trabeculo-Descemet's membrane, four mechanisms of aqueous resorption may occur: 1. a subconjunctival filtering bleb; 2. an intrascleral bleb with probable new aqueous drainage veins; 3. a suprachoroidal passage with hypotetical increased uveoscleral outfl