Postoperative complications of subconjunctival THC-YAG (Holmium) laser sclerostomy. J Am Optom Assoc 1994 May;65(5):311-20
Date
05/01/1994Pubmed ID
8071501Scopus ID
2-s2.0-0028434619 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: The THC-YAG (Holmium) laser is currently being used to create thermal sclerostomies, an alternate method of intraocular pressure control with poorly regulated glaucoma. A significant advantage of this procedure is the ab externo approach, which utilizes a small fiberoptic laser probe that is advanced subconjunctivally to the limbus. Surgical intraocular trauma is minimized, decreasing the amount of scarring and ultimate bleb failure. Complications may be seen with the THC-YAG sclerostomy and include: conjunctival burn, filtration bleb leak, posterior corneal striae, peaked pupil, iris incarceration, infection, hyphema, cataracts and ocular hypotony.
METHODS: This paper presents four glaucoma patients, co-managed at the Illinois Eye Institute, who developed complications following THC-YAG laser sclerostomy. A discussion of other possible postoperative complications and their management is included.
RESULTS: While the holmium laser has shown positive results in lowering intraocular pressure in patients with uncontrolled refractory glaucoma, complications are inherent in this procedure. The most common are posterior corneal striae, iris incarceration with secondary peaked pupil, and ocular hypotony. Conjunctival burn with secondary filtration bleb leak, limbal pigment deposition and hyphema may also be seen.
CONCLUSION: Early diagnosis and treatment of postoperative complications may help in maintaining the long term filtration ability of the sclerostomy.
Author List
Bachman JA, Conto JEAuthors
Jane Bachman Groth OD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinJohn Elliott Conto OD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedConjunctiva
Female
Glaucoma, Open-Angle
Humans
Intraocular Pressure
Laser Therapy
Male
Middle Aged
Postoperative Complications
Sclerostomy