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Pozdeyeva N.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Gorbunova N.Yu.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Frolychev I.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Voskresenskaya A.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Yakovlev R.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”

Rehabilitation of patients with posttraumatic aniridia and secondary glaucoma

Authors:

Pozdeyeva N.A., Gorbunova N.Yu., Frolychev I.A., Voskresenskaya A.A., Yakovlev R.A.

More about the authors

Journal: Russian Annals of Ophthalmology. 2023;139(6): 69‑76

DOI: 10.17116/oftalma202313906169

Views: 964

Downloaded: 23

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Table of contents

REHABILITATION OF PATIENTS WITH POSTTRAUMATIC ANIRIDIA AND SECONDARY GLAUCOMA
REHABILITATION OF PATIENTS WITH POSTTRAUMATIC ANIRIDIA AND SECONDARY GLAUCOMA

To cite this article:

Pozdeyeva NA, Gorbunova NYu, Frolychev IA, Voskresenskaya AA, Yakovlev RA. Rehabilitation of patients with posttraumatic aniridia and secondary glaucoma. Russian Annals of Ophthalmology. 2023;139(6):69‑76. (In Russ.)
https://doi.org/10.17116/oftalma202313906169

Подписка 2025-2 (Russian Annals of Ophthalmology)
 
МСФ на ЯМ
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Secondary glaucoma is one of the main problems of rehabilitation of patients with traumatic damage of the iris.

PURPOSE

This study analyzes the long-term results of rehabilitation of patients with posttraumatic aniridia and glaucoma.

MATERIAL AND METHODS

The study included 310 patients (310 eyes) with posttraumatic aniridia who had artificial iris-lens diaphragm (ILD) MIOL-Raduzhka implanted in 2002—2022. Before ILD implantation, 61 patients (22.8%) had secondary glaucoma. Among them 35 patients (11.3%) underwent various modifications of glaucoma surgery. In 26 patients (8.6%), intraocular pressure (IOP) was compensated medically before ILD implantation.

RESULTS

Until the third month after ILD implantation, there was a trend for IOP increase in some patients. Decompensation was noted in 8 (22.9%) out of 35 patients who had underwent glaucoma surgery. IOP decompensation was observed in 21 (80.8%) of 26 cases in patients with glaucoma compensated by drugs before ILD implantation. After ILD implantation, glaucoma appeared for the first time in 21 patients (6.8%) out of 310. In order to compensate IOP after ILD implantation, Ahmed valve implantation was performed most often — in 35 cases (70%) out of 50, deep sclerectomy — in 5 cases (10%), non-penetrating deep sclerectomy — in 4 cases (8%), micropulse transscleral laser cyclophotocoagulation (MP-TSCPC) — in 5 cases (10%), endoscopic cyclophotocoagulation (ECP) — in 1 case (2%).

CONCLUSION

ILD implantation in patients with posttraumatic aniridia and secondary glaucoma should be performed with IOP compensated without hypotensive therapy and not earlier than 6—12 months after glaucoma surgery. The most optimal glaucoma surgery types in this group of patients are Ahmed valve implantation and MP-TSCPC.

Keywords:

posttraumatic aniridia
secondary glaucoma
iris lens diaphragm

Authors:

Pozdeyeva N.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Gorbunova N.Yu.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Frolychev I.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Voskresenskaya A.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Postgraduate Doctors’ Training Institute

Yakovlev R.A.

Cheboksary branch of the S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”

Received:

25.10.2022

Accepted:

09.03.2023

List of references:

  1. Pozdeeva NA, Pashtaev NP. Iskusstvennaya iridokhrustalikovaya diafragma v khirurgicheskom lechenii aniridii [Artificial iridolenticular diaphragm in the surgical treatment of aniridia]. Cheboksary. 2012 (In Russ.).
  2. Pozdeeva N, Gorbunova N, Batkov Y, Pashtayev N. Ahmed glaucoma valve in cases of post-traumatic aniridia and aphakia. In: World glaucoma congress: abstract book. Paris. 2011;240. 
  3. Pozdeyeva NA, Gorbunova NYu, Pashtayev NP. Efficacy of valve drainage devices in secondary glaucoma in patients with artificial iridolenticular diaphragm. Russian Annals of Ophthalmology = Vestnik oftal’mologii. 2011;127(4): 41-45. (In Russ.).
  4. Yanoff M, Duker JS. Ophthalmology. 5th ed. Philadelphia: Elsevier Inc.; 2019;1089-1094.
  5. Zolotarev AV, Karlova EV, Nikolaeva GA. Morphology and functions of uveoscleral outflow. Russian Ophthalmological Journal. 2009;2(1):35-39. (In Russ.).
  6. Sobolev NP, Ioshin IE, Shatskikh AV, Novikov SV. Clinical morphological charactristics of iris-ciliary zone in secondary posttraumatic aniridic glaucoma. Fyodorov Journal of Ophthalmic Surgery = Oftal’mokhirurgiya. 2015; (4):17. (In Russ.).
  7. Pozdeyeva NA, Gorbunova NY. Surgical treatment of glaucoma in patients with posttraumatic aniridia. In: 14th European Glaucoma Society Congress. 13—15th December: Abstract book. 2020;293. 
  8. Haritoglou C. Artificial iris after severe trauma of the orbit. Ophthalmologe. 2015;112(7):599-601.  https://doi.org/10.1007/s00347-015-0089-4
  9. Pozdeeva NA, Frolychev IA, Pashtaev NP. Vitreoretinal’naya khirurgiya u patsientov s posttravmaticheskoi aniridiei. Fyodorov Journal of Ophthalmic Surgery= Oftal’mokhirurgiya. 2012;(3):42-47. (In Russ.).
  10. Pozdeeva NA. New model of artificial iris-lens diaphragm for correction of large iris defects (clinical and functional results of implantation). Russian Annals of Ophthalmology = Vestnik oftal’mologii. 2013;(6):38-44. (In Russ.).
  11. Pozdeeva N, Pashtaev N, Treushnikov V, Victorova E, Starostina O.A New Model of Artificial Iris-Lens Diaphragm for Extensive Iris Defects. In: World Ophtahalmology Congress: Abstract book. Abu Dhabi; 2012;63. 
  12. Pozdeyeva NA, Pashtaev NP, Lukin VP, Batkov YN. Artificial iris-lens diaphragm in reconstructive surgery for aniridia and aphakia. J Cataract Refract Surg. 2005;31(9):1750-1759. https://doi.org/10.1016/j.jcrs.2005.02.037.
  13. Pozdeyeva NA, Pashtaev NP, Frolychev IA, Sycheva DV. Penetrative keratoplasty in comprehensive treatment of course scars and epithelial and endothelial corneal distrophy in patients with posttraummatic aphakia and aniridia. Zdravookhranenie Chuvashii. 2018;(1):83-95. (In Russ.). https://doi.org/10.25589/GIDUV.2018.54.10833
  14. Yildirim N, Gursoy H, Sahin A, Ozer A, Colak E. Glaucoma after penetrating keratoplasty: incidence, risk factors, and management. J Ophthalmol. 2011;951294. https://doi.org/10.1155/2011/951294
  15. Demirok GS, Ekşioğlu Ü, Yakın M, Kaderli A, Kaderli ST, Örnek F. Short- and Long-term Results of Glaucoma Valve Implantation for Aniridia-related Glaucoma: A Case Series and Literature Review. Turk J Ophthalmol. 2019; 49(4):183-187.  https://doi.org/10.4274/tjo.galenos.2019.07348
  16. Abdelmassih Y, Tomey K, Khoueir Z. Micropulse Transscleral Cyclophotocoagulation. J Curr Glaucoma Pract. 2021;15(1):1-7.  https://doi.org/10.5005/jp-journals-10078-1298
  17. Christodoulou E, Batsos G, Parikakis E, Papadopoulos V, Karagiannis D, Koumoutsos PP, Tsilis A, Drazinos S. Combined Post-Traumatic Total Aniridia and Glaucoma Management. Case Rep Ophthalmol. 2021;12(1):204-207.  https://doi.org/10.1159/000511099

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