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.