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NR 4-6/2005
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Wpływ obciążeń
miejscowych i ogólnoustrojowych na przebieg fakotrabekulektomii
i okres pooperacyjny
Influence of local
abnormalities and systemic disorders to phacotrabeculectomy and
post-operative period
Małgorzata Figurska, Marek Rękas
Z Kliniki Okulistyki Wojskowego Instytutu Medycznego w Warszawie
Kierownik: prof. dr hab. n. med. Andrzej Stankiewicz |
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| Summary: |
The aim is to present that
local abnormalities of eyes chronically treated for
glaucoma and cardiovascular, metabolic disorders may
influence the course of phacotrabeculectomy and
post-operative period.
Material and methods: The research covered 68
patients. In 89 eyes phacoemulsification of cataract
connected with Cairns-type trabeculectomy and
implantation of lens prosthesis has been performed. The
patients were divided into two groups: I group – 37
patients, 45 surgeries. All patients were chronically
treated for arterial hypertension and other
cardiovascular disorders. 7 patients had
non-insulin-dependent type II diabetes mellitus without
diabetic retinopathy. II group – 31 patients without
cardiovascular and metabolic disorders, 44 surgeries.
Stromal atrophy and posterior synechiae were recognized
as local abnormalities (12 eyes in I group and 18 eyes
in II group). They were released during
phacotrabeculectomy.
Results: In post-operative period, higher
coefficients of complications such as hematoceles or
blood in the anterior chamber were shown in both groups,
more incidents of fibrinous reaction in I group and
exudate in the anterior chamber after release of
posterior synechiae in II group. Statistically
significant difference at p=0,016 was observed only in
comparison of the incidence of complications after
release of choroid-lens synechiae in I group, in
comparison to II group, where synechiae were not
released. Choroidal detachment was observed in 8 eyes of
I group and in 1 eye of II group. Anterior chamber
reconstructed in 3 eyes of I group and 1 of II group was
noted. In one case of booth groups, drainage of the
suprachoroid space were performed. The study didn’t show
statistically significant differences in the frequency
of fibrinous reaction or inflammatory exudates in 9 eyes
of diabetic patients, in comparison to other patients of
I group.
Conclusions: Additional procedures, especially
releasing of posterior synechiae are corelated with most
often early complications as hematoceles, hyphema in
anterior chamber, exudate or fibrinous reaction.
Cardiovascular disorders are associated with non
stability of choroidal circulation, that with
post-operative hypotony may correlated with choroidal
detachment. In patient with non-insulin-dependent type
II diabetes mellitus without diabetic retinopathy,
fibrinous reaction or inflammatory exudate, clinical
symptoms of blood-aqueous humor barrier damage were not
observed in every case. |
| Słowa kluczowe: |
fakotrabekulektomia,
powikłania, tylne zrosty tęczówkowe, choroby
ogólnoustrojowe. |
| Key words: |
phacotrabeculectomy,
complications, posterior synechiae of iris, systemic
disorders. |
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