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My Deep Sclerectomy is starting to fail.

My Deep Sclerectomy is starting to fail. Jordi Loscos Arenas MD, PhD Hospital Universitari Germans Trias i Pujol Barcelona. Failure location. _ Ab externo: Slit lamp _ Ab interno: Gonioscopy _ Surgical area : AS-OCT. Ab externo failure. _ Subconjuntival filtration decreased.

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My Deep Sclerectomy is starting to fail.

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  1. My Deep Sclerectomy is starting to fail. Jordi Loscos Arenas MD, PhD Hospital Universitari Germans Trias i Pujol Barcelona

  2. Failurelocation _ Ab externo: Slitlamp _ Ab interno: Gonioscopy _ Surgicalarea: AS-OCT

  3. Ab externo failure _ Subconjuntivalfiltrationdecreased Non increased IOP _ Increase anti-inflamatory topical therapy _ Subconjunctival Dexamethasone _ Subconjunctival Bevacizumab _ Conjunctivalmycrocystsabsence _ Increasedvascularity _ Sealedsclerallips _ Flatteningbleb Increased IOP _ Needling MMC Always consider Goniopuncture !!!

  4. Ab externo failure Needling with MMC Subconjunctival Bevacizumab

  5. Needling

  6. Ab interno failure Increased IOP _ Appositional contact between the iris and trabecular meshwork _ Peripheral anterior synechia _ TDM fibrosis _ Iris incarceration _ Goniopuncture _ Iridoplasty _ Reopening primary surgical site _ Another surgery

  7. Iridoplasty _ Spot 500 µ _ 150-200 ms _ 150-300 mW

  8. Goniopuncture _ Notbefore 2 weeks _ NdYag: 2-4 mJ _ Avoidhigh IOP _ TDM transparency _ Pilocarpine _ Iridoplasty Dr. M Javier González,Vigo

  9. Goniopuncture _ V-2000 _ V-Clip Always consider Iridoplasty !!!

  10. Iridoplasty & Goniopuncture 1_ Pilocarpine 2_ Argon Laser 3_ NdYAG

  11. Iridoplasty & Goniopuncture Nitin Anand MD Ophthalmologist Winfield Hospital,UK

  12. Iridoplasty & Goniopuncture Synechia 1_ Pilocarpine 2_ Argon Laser 3_ NdYAG Incarceration

  13. Surgicalarea: AS-OCT _ Intrascleral bleeding _ Intrascleral bridges

  14. Surgicalarea: AS-OCT _ uveal prolapse

  15. Surgicalarea: AS-OCT Transparent TDM Reopening primary surgical site Same Site Technique Another surgery

  16. SameSiteTechnique

  17. Moltes gràcies http://drloscosoftalmologia.com/

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