Purpose: To develop
operation including functioning of the basic and additional outflow duct of aqueous humor.
Material and
methods: In all, 24 patients (24 eyes) aged 59 to 73 with primary open angle
glaucoma were studied and operated. Advanced (II-c ) stage was in 10 eyes (41,7%), far-advanced (III-b) stage
in 5 eyes (20,8%), far-advanced (III-c) stage in 9 eyes (37,5%).
Operation
technique: The differ of this operation is that except for usual trabeculectomy under superficial
triangular cleral flap (3,5x3,5x2,5mm) near to its apex, step back 1 mm,
through triangular aperture (1,0x1,0x1,0) down to suprachoroidal space is made.
This deep scleral flap is divided into two parts, one of them was removed and
the other was inserted into suprachoroidal space. On the eyes with II-c,
III-b-c stages of glaucoma we additionally made posterior sclerectomy on a
standard technique.
Results: In a 3-6
month follow-up period no one of the patients has detachment of the choroid.
All patients showed normal (14-22 mm Hg by Maclacov) intraocular pressure. One
patient has hifema. In one case was formed cyst of the filtration pulvinar ,
which has disappeared after a puncture by a thick needle. The decrease of the
visual function was not observed.
Conclusion: The developed operation make an improvement of the basic and additional outflow duct. It is not difficult in performance, not accompanied by hard complications and it brings about steady normalisation of intraocular pressure. This operation in our opinion, can be spent in the future with recession of the episclera, using citostatic-antimetabolit mitomicin, with implantation of hidrogel drainage when repeated operations or neovascular glaucoma.