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العنوان
Nonpenetrating Glaucoma Surgeries and
Recent Microinvasive Glaucoma Devices /
المؤلف
El Refai, Mona Ibrahim Naguib.
هيئة الاعداد
باحث / Mona Ibrahim Naguib El Refai
مشرف / Khalid Abd AlWahab ElTagory
مشرف / Momen Mahmoud Hamdi
مشرف / Momen Mahmoud Hamdi
تاريخ النشر
2016.
عدد الصفحات
102p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
طب العيون
تاريخ الإجازة
1/1/2016
مكان الإجازة
جامعة عين شمس - كلية الطب - Ophthalmology
الفهرس
Only 14 pages are availabe for public view

from 16

from 16

Abstract

Summary
Trabeculectomy has been for many years and still the most widely
used filtering surgical procedure. However complications are
commonly observed in this type of surgery such as hypotony, collapse
of anterior chamber, cataract, hyphema, expulsive hemorrhage,
choroidal hemorrhage and detachment and endophthalmitis.
Nonpenetrating glaucoma surgeries have been developed in recent
years, in order to improve the safety of conventional filtering
procedures and decrease the incidence of complications occurring
after it.
Nonpenetrating glaucoma surgeries refer to drainage procedures
that restore aqueous humor filtration through a natural membrane, the
trabeculo-Descemet’s membrane without the penetration of anterior
chamber. It targets the presumed site of pathology, namely
Schlemm’s canal and the juxtacanalicular meshwork.
Deep sclerectomy and viscocanalostomy are the most commonly
used non-penetrating procedures.
Canaloplasty is a relatively new nonperforating blebless technique
for open-angle glaucoma, in which a microcatheter is inserted within
Schlemm’s canal for the entire 360 degrees.
All nonpenetrating glaucoma surgeries intend to achieve a
progressive reduction of intraocular pressure, limit early postoperative
hypotony, and eliminate the need for an iridectomy. As a result, they
minimize some complications of trabeculectomy.
Recently new class of procedures, termed micro-invasive
glaucoma surgery (MIGS), has raised excitement within the glaucoma
community by offering an alternative form of effective intraocular
pressure reduction associated with lower medication burden and
complication rates. Several new devices are currently being evaluated
in clinical trials and all of them have the concept of using an
alternative pathway for aqueous drainage, either Schlemm’s canal or
Summary
83
the suprachoroidal space. Early data of the use of micro invasive
glaucoma devices show great promise for the future of glaucoma
surgery.
Glaukos trabecular micro-bypass stent is an ab interno device that
seeks to augment the conventional outflow pathway of aqueous
humor by providing a direct communication between the anterior
chamber and Schlemm’s canal.
Express shunt facilitate aqueous outflow from the anterior
chamber to a subconjunctival reservoir in a similar fashion as
trabeculectomy, without removal of any sclera or iris tissue, requiring
a smaller incision into the anterior chamber.
The CyPass device is a suprachoroidal microshunt designed to
create controlled aqueous outflow from the anterior chamber into the
suprachoroidal space able to significantly lower the IOP and decrease
the medication burden.
The SOLX gold shunt is an ab externo device, designed to
transmit aqueous from the anterior chamber to the suprachoroidal
space and produce effective decrease intraocular pressure. Early
results are promising.
The Hydrus Microstent has been designed to bypass the trabecular
meshwork and scaffold and dilate approximately one quadrant of
Schlemm’s canal. It is currently in clinical trials. The Aquashunt is a
suprachoroidal device. Results data are limited at this time