The Duke Manual of Glaucoma Surgery

Description:

 

Concise, authoritative, and easy to navigate, The Duke Manual of Glaucoma Surgery offers a step-by-step, highly illustrated approach to the most commonly performed glaucoma surgeries and procedures. Ideal for glaucoma specialists, ophthalmic surgeons, residents, and fellows, it contains practical guidance from Drs. Divakar Gupta, Leon Herndon, Kelly Muir, as well as other experts at Duke University, making it an unparalleled “how-to” manual for the wide variety of cases and operative scenarios you may encounter.

 

 

Table of Contents:

 

SECTION 1: JUST THE BASICS

1 Preoperative Discussion

Review Perioperative Expectations and Considerations

Document the Discussion and Plan for Surgery

2 Setting up for Surgery

Review Your Cases in Advance

Arrive with Adequate Time, on the Day of Surgery

Time-Out with Care and Attention

Sterile Technique, Essential Steps for Preventing Infection

Positioning at the Microscope (FIG. 2.1)

SECTION 2: TRABECULECTOMY

3 Preoperative Considerations for Trabeculectomy

ANATOMICAL CONSIDERATIONS

SYSTEMIC COMORBIDITIES

LIFESTYLE

4 Different Ways to Administer Antimetabolites

SPONGE APPLICATION TO SCLERAL BED

SUBCONJUNCTIVAL INJECTION

Preoperative

Intraoperative

Postoperative

5 Limbal Versus Fornix Conjunctival Flap

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE: LIMBAL CONJUNCTIVAL FLAP

SURGICAL PROCEDURE: FORNIX CONJUNCTIVAL FLAP

6 Steps of a Trabeculectomy

SURGICAL PROCEDURE

Place Traction Suture

Conjunctival Peritomy (Fig. 6.1)

Clean Sclera

Create Flap

Administer Mitomycin C (see Chapter 4)

Create a Paracentesis

Enter the Anterior Chamber

Close Flap

Close Conjunctiva

Check for Leaks

7 Scleral Flap and Sclerostomy Construction

SURGICAL PROCEDURE

8 Ex-Press Shunt Implantation With Mitomycin C

SURGICAL PROCEDURE (VIDEO 8.1)

9 Releasable Sutures

CONSIDERATIONS

Releasable Suture Planning

SURGICAL PROCEDURE (VIDEO 9.1)

Kolker Technique1

Modified Kolker Technique (Fig. 9.1)

Release of Suture

Other Considerations

10 Conjunctival Closures

PREOPERATIVE CONSIDERATIONS

Belt and Suspenders Planning

Watertight Closure Planning

SURGICAL PROCEDURE: INTERRUPTED SUTURES—BELT AND SUSPENDERS

SURGICAL PROCEDURE: MODIFIED HORIZONTAL MATTRESS SUTURING

CHOOSING A SURGICAL CLOSURE

Interrupted Sutures—Belt and Suspenders

Modified Horizontal Mattress—Modified Wise

11 Postoperative Medications and Manipulations for Trabeculectomy

POSTTRABECULECTOMY MANAGEMENT

Outpatient Medications

Frequency of Office Visits

Laser Suture Lysis

PROCEDURE: LASER SUTURE LYSIS

PROCEDURE: 5-FU INJECTION

PROCEDURE: INTRACAMERAL TPA INJECTION

PROCEDURE: BLEB NEEDLING (AT THE SLIT LAMP)

PROCEDURE: INJECTION OF VISCOELASTIC INTO THE ANTERIOR CHAMBER

PROCEDURE: IRRIGATING OUT VISCOELASTIC FROM THE ANTERIOR CHAMBER

A FINAL COMMENT REGARDING POSTTRABECULECTOMY MANAGEMENT…

SECTION 3: TUBE SHUNTS

12 Preoperative Planning and Considerations for Tube Shunts

PATIENT HISTORY

CLINICAL EXAMINATION

TUBE IMPLANT CONSIDERATIONS

13 Types of Shunts, Tube Ligation, Patch Materials

TYPES OF SHUNTS

Nonvalved Tube Shunts (in Alphabetical Order by Current Manufacturer)

Valved Glaucoma Shunt Tubes: (in Alphabetical Order by Current Manufacturer)

TUBE LIGATION

PATCH MATERIALS

Human Cornea

Human Sclera

Human Pericardium

Less Common Alternatives

14 Ahmed Valved Tube Shunt

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE: AHMED TUBE IMPLANT

15 Nonvalved Tube Shunt

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE (VIDEO 15.1)

Preparing the Tube Shunt

Implanting the Tube Shunt

SURGICAL PEARLS

16 Tube Placement Locations

PREOPERATIVE CONSIDERATIONS

Plate Quadrant

Tube Location

SURGICAL PROCEDURE: ANTERIOR CHAMBER TUBE PLACEMENT

SURGICAL PROCEDURE: IRIDOCILIARY SULCUS TUBE PLACEMENT

SURGICAL PROCEDURE: PARS PLANA TUBE PLACEMENT

Tube Placement Planning

Procedure

SURGICAL PROCEDURE: INTRACAMERAL TUBE TRIMMING

Planning

Procedure

17 Special Cases: Neovascular and Uveitic Glaucoma

NEOVASCULAR GLAUCOMA

UVEITIC GLAUCOMA

18 Special Cases: Prior Scleral Buckle

PREOPERATIVE CONSIDERATIONS

SURGICAL PLANNING

Presurgical

Instruments Needed

SURGICAL PROCEDURE: GLAUCOMA DRAINAGE DEVICE

SURGICAL PROCEDURE: MODIFIED SCHOCKET

SURGICAL PROCEDURE: SCHOCKMED IMPLANT

Indications

Surgical Steps

Alternatively

19 Postoperative Medications and Manipulations for Tube Shunts

VALVED IMPLANTS (EG, AHMED FP7)

Postoperative Medication Course

Postoperative Visit Frequency

NONVALVED IMPLANTS (EG, BAERVELDT, CLEARPATH, MOLTENO)

Postoperative Medication Course

Postoperative Visit Frequency

POSTOPERATIVE MANIPULATIONS FOR TUBE SHUNTS

Pulling the Ripcord

Flat Anterior Chamber

Tube Obstruction

USING ANTIMETABOLITES WITH VALVED GLAUCOMA IMPLANTS

SECTION 4: ANGLE-BASED SURGERY

20 Preoperative Considerations for Angle-Based Surgery

PATIENT SELECTION

ANATOMICAL CONSIDERATIONS

COMORBIDITIES

21 Intraoperative Gonioscopy

PREOPERATIVE CONSIDERATIONS

Instruments Needed

SURGICAL PROCEDURE (ASSUMING A TEMPORAL APPROACH)

22 Trabecular Meshwork Stents

PREOPERATIVE CONSIDERATIONS

Anatomy

Conditions Which May Prohibit Visualization

iStent (2012)—Single Bypass

iStent Inject (2018)—Multiple Bypass

Hydrus Microstent (2018)—Single Bypass, Scaffold Dilates Schlemm Canal 90 degrees

iStent, iStent Inject, and Hydrus Microstent Planning

SURGICAL PROCEDURE

iStent

iStent Inject (Fig. 22.1)

Hydrus (Fig. 22.2 and VIDEO 22.1)

Most Common Adverse Events

23 Ab Interno Trabeculotomy: Trabectome

TRABECTOME PLANNING

Presurgical

Instruments Needed

SURGICAL DEVICE (FIG. 23.3)

SURGICAL PROCEDURE: STANDALONE TRABECTOME SURGERY

SURGICAL PROCEDURE: TRABECTOME COMBINED WITH PHACOEMULSIFICATION

24 Goniotomy With the Kahook Dual Blade

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE (VIDEO 24.1)

Standalone

With Cataract Extraction

25 Ab Interno Trabeculotomy and Viscocanaloplasty

PREOPERATIVE CONSIDERATIONS

Patient Selection

Instruments Needed

SURGICAL PROCEDURE (FIG. 25.2)

POSTOPERATIVE CONSIDERATIONS

26 Goniosynechialysis

PREOPERATIVE CONSIDERATIONS

GONIOSYNECHIALYSIS PLANNING

Presurgical

Instruments Needed

SURGICAL PROCEDURE (FIG. 26.1)

Steps

AVAILABLE ONLINE VIDEOS

27 Postoperative Medications and Considerations for Angle-Based Surgery

TOPICAL ANTIBIOTICS

CORTICOSTEROIDS AND/OR NONSTEROIDAL AGENTS (NSAIDS)

Angle-Based Procedures

Subconjunctival Bypass

Cycloablative Lasers (Endoscopic Cyclophotocoagulation)

TOPICAL PILOCARPINE 1% OR 2%

Approach 1

Approach 2

Approach 3

TOPICAL GLAUCOMA MEDICATION

Approach 1

Approach 2

SECTION 5: SUBCONJUNCTIVAL BYPASS

28 Preoperative Considerations for XEN Implantation

PATIENT SELECTION

ANATOMICAL CONSIDERATIONS

29 XEN Ab Interno Implantation

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE

Standalone

With Cataract Extraction

30 XEN Ab Externo Implantation

PREOPERATIVE CONSIDERATIONS

Presurgical

Instruments Needed

SURGICAL PROCEDURE (FIG. 30.1 and VIDEO 30.1)

31 Postoperative Considerations for XEN Implantation

INITIAL POSTOPERATIVE MANAGEMENT

INITIAL POSTOPERATIVE COMPLICATIONS

LONG-TERM POSTOPERATIVE MANAGEMENT

SECTION 6: CYCLOBLATIVE LASER

32 Preoperative Planning and Considerations for Cyclophotocoagulation

AIM OF PROCEDURE: DECREASE INTRAOCULAR PRESSURE BY REDUCING AQUEOUS PRODUCTION

CURRENT OPTIONS

INDICATIONS

PERIOPERATIVE CONSIDERATIONS

POSTOPERATIVE CONSIDERATIONS

COMPLICATIONS

ANESTHESIA OPTIONS

33 Endocyclophotocoagulation

PREOPERATIVE CONSIDERATIONS

PLANNING

SURGICAL PROCEDURE (VIDEO 33.1)

34 Transscleral Diode Cyclophotocoagulation

PLANNING

Patient Selection

Equipment

PROCEDURE (FIG. 34.1)

POSTOPERATIVE CARE AND FOLLOW-UP

COMPLICATIONS

35 Micropulse Cyclophotocoagulation

PREOPERATIVE CONSIDERATIONS

Anesthesia Considerations

Laser Settings

Instruments Needed

SURGICAL PROCEDURE (FIG. 35.1 AND VIDEO 35.1)

POSTOPERATIVE CONSIDERATIONS

SURGICAL PEARLS

SECTION 7: CATARACT AND LENS SURGERY IN THE GLAUCOMA PATIENT

36 Preoperative Planning for Cataract and Lens Surgery in the Glaucoma Patient

CONSIDERATION 1: CATARACT SURGERY ALONE

Narrow-Angle Glaucomas

Open-Angle Glaucomas

CONSIDERATION 2: CATARACT SURGERY WITH MICROINVASIVE GLAUCOMA SURGERY

Narrow-Angle Glaucomas

Open-Angle Glaucomas

CONSIDERATION 3: CATARACT SURGERY WITH FILTERING SURGERY/TUBE SHUNT

Narrow-Angle Glaucomas

Open-Angle Glaucomas

OTHER CONSIDERATIONS

37 Considerations for Combined Cataract and Glaucoma Surgery

PREOPERATIVE EVALUATION

Glaucoma Medications

Visual Acuity

Intraocular Pressure

Gonioscopy

Slit Lamp Examination

Optic Nerve Examination and Retina Evaluation

Visual Field (Fig. 37.1)

Follow-up

Intraocular Lens Choice

SURGICAL TECHNIQUES

ANESTHESIA CONSIDERATIONS

POSTOPERATIVE MANAGEMENT

COMPLICATIONS

38 Special Cases: Angle Closure

PREOPERATIVE PLANNING

Examination

Informed Consent

SURGICAL PROCEDURE

POSTOPERATIVE CARE AND FOLLOW-UP

39 Special Cases: Nanophthalmos

SMALL EYES: ARE THEY ALL THE SAME?

SMALL EYE PHENOTYPES

Axial Hyperopia

Relative Anterior Microphthalmos

Microphthalmos

Nanophthalmos

CATARACT SURGERY IN NANOPHTHAMIC AND MICROPTHALMIC EYES

SURGICAL PLANNING IS KEY

Increased Surgical Risks for

SURGICAL MANAGEMENT

Prevention of Iris Prolapse and Damage

Deepen the Anterior Chamber With

Plan for Intraoperative Uveal Effusions

LITERATURE REVIEW

CONCLUSIONS

40 Special Cases: Exfoliation Syndrome

PREOPERATIVE CONSIDERATIONS

Presurgical

Day of Surgery

SURGICAL PROCEDURE

41 Clinical Evaluation and Surgical Management of Subluxed and Dislocated Intraocular Lens Implant

DEFINITION

ETIOLOGY OF IOL DISLOCATION

PREOPERATIVE EVALUATION AND OPERATIVE PLANNING

IOL ROTATION OF DECENTERED THREE-PIECE IOL IN SULCUS

FIXATING THE INTRACAPSULAR IOL-CAPSULAR COMPLEX TO IRIS OR SCLERA

FIXATION OF EXTRACAPSULAR THREE-PIECE IOL TO IRIS

SUTURE FIXATION OF THE IOL-CAPSULAR COMPLEX TO SCLERA—FOR INTACAPSULAR SINGLE-PIECE OR THREE-PIECE IOL DISLOCATION

IOL HAPTIC FIXATION TO SCLERA—EXTRACAPSULAR SUBLUXATION OF THREE-PIECE IOL OR WITH EXCHANGE PLACEMENT OF THREE-PIECE IOL

OTHER OPTIONS FOR IOL EXCHANGE WITH SCLERAL FIXATION OF IMPLANTED IOL

IOL EXCHANGE WITH PLACEMENT OF ACIOL

42 Secondary IOL Placement: Sulcus, Sutured, ACIOL

PREOPERATIVE CONSIDERATIONS

SULCUS IOL PLANNING

Presurgical

Instruments

SURGICAL PROCEDURE: SULCUS IOL

SUTURED IOL PLANNING

Presurgical

Instruments

SURGICAL PROCEDURE: IRIS-SUTURED IOL

ACIOL PLANNING

Presurgical

Instruments

SURGICAL PROCEDURE: ACIOL

SECTION 8: TRABECULECTOMY REVISIONS

43 Preoperative Considerations for Trabeculectomy Revisions

DETERMINE THE REASON NECESSITATING SURGICAL REVISION

CONSIDER THE BLEB MORPHOLOGY

CONSIDER THE LID POSITION

44 Excision and Pull Down

PREOPERATIVE CONSIDERATIONS

PREOPERATIVE PLANNING

Presurgical

Instruments Needed

SURGICAL PROCEDURE

POSTOPERATIVE CONSIDERATIONS

45 Conjunctival Autograft

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE (ASSUMING SUPERIOR TRABECULECTOMY REVISION)

46 Transconjunctival Suturing

INTRODUCTION AND DEFINITIONS

Bleb Dysesthesia

Overfiltering Bleb

EVALUATION OF HYPOTONY AND THE EYE WITH BLEB DYSESTHESIA

Evaluation of the Conjunctival Filtering Bleb

AC Depth

Iris

Gonioscopy

Vitreous

Peripheral Retina and Macula

MANAGEMENT OF THE OVERFILTERING BLEB

Instruments Needed

Surgical Technique

47 Bleb Compression Sutures

PREOPERATIVE CONSIDERATIONS

Presurgical

Instruments Needed

SURGICAL PROCEDURE

48 Revisions for Bleb Dysesthesia

COMPRESSION SUTURES

TRANSCONJUNCTIVAL SUTURE (SEE CHAPTER 52)

BLEB-LIMITING TECHNIQUES

BLEB WINDOW CRYOPEXY (VIDEO 48.1)

BLEB DYSESTHESIA ASSOCIATED WITH ANTERIOR BLEB MIGRATION

SECTION 9: TUBE SHUNT REVISIONS

49 Preoperative Planning and Considerations for Tube Shunt Revisions

50 Tube Shunt Revision for Exposure

PREOPERATIVE CONSIDERATIONS

Tube Revision Planning

SURGICAL PROCEDURE: TUBE REVISION FOR EXPOSURE (FIG. 50.1)

51 Tube Shunt Repositioning

PREOPERATIVE CONSIDERATIONS

Tube Repositioning Planning

SURGICAL PROCEDURE: TUBE REPOSITIONING (FIG. 51.1)

52 Tube Extender

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE: AHMED TUBE EXTENDER (VIDEO 52.1)

53 Tube Shunt Revision for Hypotony

INTRAOCULAR REVISION

Ligation of Tube in the Anterior Chamber

Insertion of Suture into Tube Lumen

EXTRAOCULAR REVISION

Revision With Tube Occlusion

Altering the Reservoir Size

Tube Removal

SECTION 10: CHALLENGING SURGICAL CASES

54 Management of Intraoperative Malignant Glaucoma

“PSEUDOMALIGNANT” GLAUCOMA

55 Management of Hemorrhagic Choroidals

SURGICAL DRAINAGE STEPS (FIG. 55.1)

SURGICAL PEARLS

56 Scleral Windows in Nanophthalmos

PREOPERATIVE CONSIDERATIONS

SURGICAL PROCEDURE (FIG. 56.1 and VIDEO 56.1)

POSTOPERATIVE CONSIDERATIONS

57 Drainage of Serous Choroidals

PREOPERATIVE CONSIDERATIONS

Surgical Planning

SURGICAL PROCEDURE: DRAINAGE OF CHOROIDAL DETACHMENT

58 Cyclodialysis Cleft Repair

SECTION 11: CLINIC LASERS

59 Selective Laser Trabeculoplasty

PLANNING

Patient Selection

Equipment

PROCEDURE (FIG. 59.1)

POSTOPERATIVE/FOLLOW-UP CARE

60 Peripheral Iridotomy

PREOPERATIVE CONSIDERATIONS

PROCEDURE PLANNING

Instruments and Medications Needed

PREPROCEDURE PREPARATION

LASER PERIPHERAL IRIDOTOMY PROCEDURE

POSTOPERATIVE MANAGEMENT

COMMON COMPLICATIONS

61 Iridoplasty

PLANNING

Patient Selection

Equipment

PROCEDURE (FIG. 61.1)

POSTOPERATIVE CARE AND FOLLOW-UP

COMPLICATIONS

Index

 

 

An aparitie	01/09.2021
Autor	Divakar Gupta, Kelly Muir, Leon Herndon, Jr.
Dimensiuni	178 x 254 mm
Editura	LWW
Format	Paperback
ISBN	9781975150563
Limba	Engleza
Nr pag	272