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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.07.02 Suprachoroidal drainage implants for intractable glaucoma Jordan J. F., Konen W., Dietlein T. S., Krieglstein G. K.
Zentrum für Augenheilkunde, Universität zu Köln, Köln The process of wound healing is still the most crucial factor determining both short and long-term success of glaucoma filtration surgery. The application of antimetabolites has improved its functional outcome, but by far not solved the problem. For eyes with intractable glaucoma, the classic drainage implants provide an additional approach to IOP control. All these devices are placed and fixed episclerally, draining aqueous from the anterior chamber to the subconjunctival space. Subsequently they are accompanied by complications such as severe initial hypotony, suprachoroidal hemorrhage, conjunctival erosion, and infection. Furthermore, the problem of subconjunctival scarring remains and still limits functional mid- and long-term outcome.
As an alternative approach, we discuss drainage of aqueous from the anterior chamber to the suprachoroidal space. The surgical approach exploits the resorptive capability of the choroid. The difference in hydrostatic pressure guarantees for drainage, but also provides a natural counterpressure to avoid hypotony. In the context of current literature, recent investigations on uveoscleral glaucoma-implants are presented: i.a. (I) the Uveoscleral Shunt with its intrascleral course, (II) the Goldshunt and (III) the gonioscopic approach via Cyclodialysis ab-interno.
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