3082: Glaucoma, OCP, monocular patient – 10/10 tough
Managing a high-complexity case in a monocular patient with ocular cicatricial pemphigoid (OCP) and advanced glaucoma requires a carefully orchestrated surgical approach. To minimize intraocular energy and protect a fragile ocular surface, manual extra-capsular extraction of the nucleus through a larger, securely sutured incision provides a controlled path for lens removal. Addressing the glaucoma simultaneously involves a dual mechanism strategy: endocyclophotocoagulation is performed to ablate ciliary processes and decrease aqueous humor production, while an AlloFlow tissue allograft is deployed to enhance outflow via a cyclodialysis cleft, providing sustained intraocular pressure control without disturbing the conjunctiva. Watch the video to see the surgical execution of manual nuclear extraction combined with endocyclophotocoagulation and AlloFlow placement in this challenging monocular OCP patient. What is your primary surgical approach when managing advanced glaucoma alongside cataract extraction in severe ocular surface disease? Please comment your thoughts below.
