Small and flat anterior chamber and glaucoma

Depending on the etiology, high or low intraocular pressure is recorded with flat chambers. The doctor establishes a diagnosis based on the detection of a flat or shallow chamber in the postoperative period, clinical history, examination data, and the level of intraocular pressure.

Indications for drainage of choroidal detachment: flat chamber with contact of the lens and cornea, "kissing choroidal bubbles" (retinoretinal contact between choroidal detachments) to avoid the formation of fibrinous retinal adhesions and persistence of the process (after treatment with cycloplegic drugs and local glucocorticoids). It is necessary to observe patients with such symptoms for several weeks, as long as at least one of these pathologies is present.

Anterior chamber reconstruction methods

• Pressure tamponade or Simmon's sink is a method that is more successful after operations without the use of antimetabolites and is used in hyperfiltration.
• Injection of viscoelastic into the anterior chamber is a more effective method in filtering surgery without the use of antimetabolite drugs.
• Flap stitching is a method that helps to quickly complete the process after using antimetabolites.

Drainage of choroidal detachment

• Temporary paracentesis.
• Conjunctival incisions at the 4:30 and 7:30 hour meridians are made at a distance of 2 to 7 mm from the limbus, or limbal peritomy at the 4 to 8 o'clock positions.
• Radial cuts half the thickness of 2 mm, 3 mm from the limb with distance measurement using a compass.
• Grasping the edge of the flap with serrated surgical tweezers and pulling it back.
• Using a sharp blade, the incision is slowly and carefully deepened until it penetrates into the suprachoroidal space.
• Enlarging the cut with a Kelly punch.
• If the incision is over a fluid pocket, fluid will flow out, more so when introducing BSS solution through paracentesis, lifting the edges of the flap, blotting and changing the sponge on the surface of the sclera.
• If the incision is not over a cavity with fluid, and the fluid does not come out of the incision, cyclodialysis with a spatula can be used to penetrate into the adjacent pocket and carefully separate the choroid from the scleral wall. Such separation should be done extremely carefully, no more than a few millimeters from the incision.
• Indirect ophthalmoscopy is performed to see the retina that has become flat. The anterior chamber should also become deep.
• The conjunctival incisions should be sutured, leaving the perforated incisions open.

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