Operation in glaucoma, as a cure for the treatment of disease
In glaucoma, there is an increase in intraocular pressure, which is constant or periodic, causing degenerative-dystrophic changes in the optic nerves. In uncomplicated cases and in the early stages of the disease conservative, and even folk methods of treatment are used. But if such therapy does not work, surgery is performed with glaucoma.
Surgical treatment of glaucoma
The history of the surgical treatment of glaucoma has more than one century. Even in the time of Avicenna, micro-operations were performed, the purpose of which was to restore the outflow of intraocular fluid. If previously only traditional techniques of operations were used, then more advanced modern technologies are used, when operations are performed with the help of a laser.
The effectiveness after operations on the eyes in glaucoma is almost 100%, and all operations for glaucoma are divided into two types:
- Laser methods of microsurgery - when the laser beam restores fluid drainage and operations are carried out mainly in the iris. Advantages of laser surgery - restoration of outflow of fluid through its natural channels, non-invasiveness of the method and a small percentage of complications during and after operations. Practically in 2 days patients can already look in their usual mode, and completely vision is restored in a week.
- In cases where the process is neglected and can not be laser-assisted, conventional conventional techniques are used. Among them are operations that aim to restore natural filtration by creating new ways for fluid outflow.
Surgical treatment of glaucoma does not prevent further degenerative-dystrophic changes in the eyes, therefore in some cases a repeated operation or correction of outflow of fluid is required. For example, an angle-closure glaucoma is difficult to treat, even with surgery. Therefore, with this form of the disease, the closed-angle glaucoma is transferred to the open-ended, which is treated easier, or during the operation, the lens is replaced with glaucoma for a similar artificial implant.
Laser operations are performed as follows:
- Laser iridectomy - the laser creates an artificial hole in the outer edge of the iris, which prevents the increase in intraocular pressure and the deterioration of fluid circulation. It is widely used in glaucoma, the treatment of which by conservative methods is ineffective. After such an operation, complications can occur that result in a distortion of vision( within 3-4 weeks), corneal edema and occlusion of the hole made. In the latter case, they resort to a second operation.
- Laser trabeculoplasty - the advantages of the method is that the operation is performed on an outpatient basis and takes 10-20 minutes. There are two types of such surgical intervention - argon and selective. These types are applied individually in each case, and the choice of operation is affected by the complexity of the course of glaucoma and the patient's condition. Selective trabeculoplasty can be carried out in several stages, and argon - one-time.
- Laser ciliolyablation - which is also called destruction of the ciliary body. The essence of the operation is that with the help of the laser, the ciliary body is partially destroyed, the task of which is the production of fluid for the eye. This form of surgery is most often used in severe cases of glaucoma or with complications from other organs and systems.
Microsurgical surgical interventions are as follows:
- Trabeculectomy - in which a part of the clogged drainage system is surgically removed so that the fluid flows freely out of the eyes. From the conjunctiva, a vesicle is reconstituted, which from now on will accumulate the fluid that flows out of the eye. The vial is located under the upper eyelid, from where the fluid is naturally absorbed into the bloodstream and leaves.
- Surgery for shunting implants or tubes - which are inserted into the eye cavity to provide drainage. In the space behind the conjunctiva, a reservoir is inserted, where the liquid freely flows through the micro-shunts from the eye cavity.
- Viscocanalostomy - at which part of the sclerotic membrane is removed, as a result of which a thin tissue remains in its place, through which the liquid from the eye is filtered, thereby reducing the intraocular pressure.
With the disease of glaucoma, the postoperative period proceeds relatively smoothly. Patients are given a protective bandage over their eyes and any physical exertion is prohibited until vision is restored and the patient can move independently.