1013: Playlist: Glaucoma Cases

The most commonly performed glaucoma surgery is…. cataract surgery! We know that doing cataract surgery alone can lower intra-ocular pressure in all eyes by a significant degree. For eyes with narrow angles, removing the 4+mm thick cataract and replacing it with a 1mm thin IOL will immediately widen the angle and improve outflow drainage. There are also times where we will need to perform glaucoma surgery, either alone or in combination with cataract surgery. This playlist showcases four great learning cases.

Dr Mohamed Sayed from Miami, Florida, USA shows us that small incision glaucoma seton placement can be done, minimizing the size of the conjunctival incision.
Dr Val Apostolov from Amsterdam, NL shows us his technique for placing a glaucoma drainage implant. His method of burying the tube within the sclera is excellent, as is his technique for placing and then removing a blockage suture.
There are times when surgical peripheral iridotomy is better than a laser created one. This video teaches the technique of using the 23g vitrector to create surgical PIs.
This is a video from a senior resident at our program and he does a great job with this very tough cataract case. Note that we did not use iris hooks or a pupil ring because that would have damaged the iris sphincter and resulted in chronic mydriasis (the patient has a non-reactive pupil even after breaking the synechaie). The best part of the case is the quick and easy release of scar tissue around the glaucoma seton footplate to re-establish fluid flow which is then confirmed by the triamcinolone particles.

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