Retinectomy Lowers Intraocular Pressure in Otherwise Intractable Glaucoma. Long-Term Follow-Up

Abstract

Treatment of glaucoma that is unresponsive to conventional therapy has, until recently, been singularly disappointing. Treatment options for intractable glaucomas fall into two groups: those reducing aqueous production and those enhancing aqueous outflow. Cyclodestructive procedures have a high rate of serious complications, which include visual loss, phthisis (especially in eyes with neovascular glaucoma), severe pain and inflammation, and transient postoperative intraocular pressure (IOP) elevation that, at times, can be profound. Conventional filtration procedures are disappointing for three reasons: early hypotony often leads to choroidal detachment, continuing proliferation of fibrovascular tissue invariably blocks off the internal opening of the fistula and bleb fibrosis causes similar obstruction to the external opening of the fistula. Antiproliferative drugs are applied to inhibit excessive scarring after filtration surgery.