CLASSIFICATION ULTRABIOMICROSCOPIC CRITERIA OF VALIDITY OF INTRAOCULAR FLUID OUTFLOW PATHWAYS AFTER FISTULIZING ANTIGLAUCOMATOUS SURGERY
Abstract and keywords
Abstract (English):
The objective assessment of status of intraocular fluid outflow pathways after fistulizing antiglaucomatous surgery is a necessary efficacy prediction component of glaucoma surgery. Based on complex assessment of operative zone, includ-ing ultrasound biomicroscopy, at different dates after non-penetrating deep sclerotomy the attempt of development of clinical classification of fluid outflow pathways was made. The basis of this classification is sign of morphological heterogeneity of the examined structures. In the study the parameters of the functional state of the trabeculae-Descemet’s membrane were determined: the height 0.8±0.09mm, thickness 0.09±0.004mm and acoustic density <55±10%; timelines of sclerosis – 1–1.5months after surgery. This was the rationale for the principle of a two-stage non-penetrating deep sclerectomy and indica-tion for laser descemetogoniopuncture in terms of 1–1.5months after the operation in the absolute number of cases. Postoperative UBM monitoring allowed determining the period of active remodeling of newly formed intraocular fluid outflow pathways in norm and their pathological formation – 6months after the intervention. Developed system of assessment of surgically formed fluid outflow pathways by proposed method allows monitor dynamics of fluid outflow pathways forming, standardize results and determine choice of further treatment.

Keywords:
ultrasound biomicroscopy, classification of the intraocular fluid outflow pathways, non-penetrating deep sclerectomy, Yag-laser goniopuncture
References

1. VolkovaNV, YurevaTN, ShchukoAG, MalyshevVV(2008). Classification of intraocular fluid outflow pathways after fistulizing antiglaucomatous operations [Klassifikatsiya putey ottoka vnutriglaznoy zhidkosti posle fistuliziruyushchikh antiglaukomatoznykh operatsiy]. Glaukoma, (3), 16-20.

2. VolkovaNV, ShchukoAG, MalyshevVV (2010). Retrospective analysis of risk factors for development of scarring intraocular fluid outflow pathways after fistulizing antiglaucomatous operations [Retrospektivnyy analiz faktorov riska razvitiya rubtsovykh izmeneniy putey ottoka vnutriglaznoy zhidkosti posle fistuliziruyushchikh antiglaukomatoznykh operatsiy]. Glaukoma, (3), 35-40.

3. VolkovaNV, ShchukoAG, MalyshevaYV, YurevaTN (2014). Inadequate reparative regeneration in fistulizing glaucoma surgery [Neadekvatnaya reparativnaya regeneratsiya v fistuliziruyushchey khirurgii glaukomy]. Oftal’mokhirurgiya, (3), 60-66.

4. KuryshevaNI, MarnykhSA, BorzinokSA (2005). The use of physiological regulators of reparation in glaucoma surgery (clinical and immunological research) [Primenenie fiziologicheskikh regulyatorov reparatsii v khirurgii glaukomy (kliniko-immunologicheskoe issledovanie)]. Vestnik oftal’mologii, (6), 21-25.

5. TakhchidiKP, EgorovaEV, UzunyanDG (2007).Ultrasound biomicroscopy in the diagnosis of diseases of anterior segment of the eye [Ul’trazvukovaya biomikroskopiya v diagnostike patologii perednego segmenta glaza], 73-86.

6. TitovVN (2003). The role of macrophages in the development of inflammation, the action of interleukin-1, interleukin-6 and activity of hypothalamic-hypophysis system (literature review) [Rol’ makrofagov v stanovlenii vospaleniya, deystvie interleykina-1, interleykina-6 i aktivnost’ gipotalyamo-gipofizarnoy sistemy (obzor literatury)]. Klinicheskaya laboratornaya diagnostika, (12), 3-10.

7. TitovVN, OshchepkovaEV, DmitrievVA (2005). Endogenous inflammation and biochemical aspects of the pathogenesis of hypertension [Endogennoe vospalenie i biokhimicheskie aspekty patogeneza arterial’noy gipertonii]. Klinicheskaya laboratornaya diagnostika, (5), 3-10

8. FyodorovSN, KozlovVI, TimoshkinaNT (1989). Non-penetrating deep sclerectomy for open-angle glaucoma [Nepronikayushchaya glubokaya sklerektomiya pri otkrytougol’noy glaukome]. Oftal’mokhirurgiya, (3-4), 52-55.

9. YurevaTN, VolkovaNV, ShchukoAG, MalyshevVV(2007). Algorithm of rehabilitation measures at the stages of formation of the outflow pathways after penetrating deep sclerectomy [Algoritm reabilitatsionnykh meropriyatiy na etapakh formirovaniya putey ottoka posle nepronikayushchey glubokoy sklerektomii]. Oftal’mokhirurgiya, (4), 67-71

10. CantorLB (2003). Morphologic classification of filtering blebs after glaucoma filtration surgery: the Indiana Bleb Appearance Grading Scale. J. Glaucoma, (12), 266-271.

11. ChangL, ChengQ, LeeDA (1998). Basic science and clinical aspects of wound healing in glaucoma filtering surgery. J. Ocul. Pharmacol. Ther., (14), 75-95.

12. ChangL, CrowstonJG, CordeiroMF (2000). The role of the immune system in conjunctival wound healing after glaucoma surgery. Surv. Ophthtalmol., (45), 49-68.

13. FurrerS, MenkeMN, FunkJ (2012). Evaluation of filtering bleb using the «Würzburg bleb classification scoe» compared to clinical findings. BMC Ophthalmol., (17), 12-24.

14. HowA, ChuaJL, CharltonA (2010). Combined treatment with bevacizumab and 5-fluorouracil attenuates the postoperative scarring response after experimental glaucoma filtration surgery. Invest. Ophthalmol. Vis. Sci., 51(2), 928-932

15. LamaPJ, FecthnerRD (2003). Antifibrotics and wound healing in glaucoma surgery. Surv. Ophthalmol., 48(3), 314-346

16. ReynoldsAC, SkutaGL (2000). Clinical perspectives on glaucoma filtrering surgery. Antiproliferative agents. Ophthalmol. Сlin. North America, 13(3), 501-515.

17. ShaarawyTM, SherwoodMB, HitchingsRA (2009). Glaucoma. Philadelphia: Saunders Elsevier, (1), 383-392.

18. ThamCC, LiFC, LeungDY (2006). Intra bleb triamcinolone acetonide injection after bleb-forming filtration surgery (trabeculectomy, phacotrabeculectomy, and trabeculectomy revision by needling): a pilot study. Eye, (13), 454-460

19. WellsAP, CrowstonJG, MarksJ (2004). A pilot study of a system for grading of drainage blebs after glaucoma surgery. J. Glaucoma, (13), 454-460.

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