Small and flat anterior chamber and glaucoma
Last reviewed: 23.04.2024
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Depending on the etiology in the case of flat chambers, high or low intraocular pressure is recorded. The doctor sets the diagnosis based on the detection of a flat or shallow chamber in the postoperative period, a clinical history, examination data and the level of intraocular pressure.
Indications for draining the choroidal detachment: a flat chamber with the contact of the lens and the cornea, "kissing bubbles of choroid" (retinoretinal contact between choroid detachments) to avoid the formation of fibrinous retinal adhesions and the persistence of the process (after treatment with cycloplegic drugs and local glucocorticoids). It is necessary to observe patients with similar symptoms for several weeks, while there is at least one of these pathologies.
Methods for restoring the anterior chamber
- Tamponade pressure or Simmon's shell (Simmon) - a method more successful after operations without the use of antimetabolites, is used in hyperfiltration.
- Injection of viscoelastic into the anterior chamber - the method is more effective in filtering operations without the use of antimetabolics.
- Flap flashing - the method promotes an early completion of the process after using antimetabolites.
Draining of choroidal detachment
- Temporary paracentesis.
- Conjunctival incisions at 4:30 and 7:30 hour meridians are done at a distance of 2 to 7 mm from the limbus or limbal peritomy at positions 4 to 8 hours.
- Radial incisions are half the thickness of 2 mm, 3 mm from the limb with distance measurement by a compass.
- Grab the edge of the flap with serrated surgical tweezers and pull it.
- With a sharp blade, the incision is slowly and gently deepened until it penetrates the suprachoidal space.
- Extension of the cut by Kelly's perforator.
- If the incision is above the pocket with liquid, it flows out more when the BSS solution is injected through the paracentesis, lifting the edges of the flap, blotting and changing the sponge on the sclera surface.
- If the incision is not above the cavity with the liquid, but it does not come out of the incision, for penetration into the adjacent pocket and careful separation of the choroid from the scleral wall, it is possible to conduct the cyclodialysis with a spatula. This stratification should be carried out very carefully, no more than a few millimeters from the cut.
- Indirect ophthalmoscopy is performed in order to see the flattened retina. The front camera should also become deep.
- Conjunctival incisions need to be sewn, leaving the perforated incisions open.
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