V 516
Surgical interventions in glaucoma after most severe eye burns
R. Kuckelkorn, C. Redbrake
Background: Glaucoma after most severe eye burns are extremely hard to control as well as hard to treat. In our study we report about our experience with glaucoma implants and lasercyclodestruction with the diode laser in most severe eye burns.
Patients: 14 eyes of 13 patients were investigated retrospectively. All patients suffered from a most severe burn (grade 4). In 9 cases an implant was carried out to decrease intraocular pressure (3 Ahmed, 6 von-Denffer-implants). Follow-up was 38±5 months in patients with Ahmed valves and 45 ± 36 months in von-Denffer implants. In 5 cases a lasercyclodestruction was carried out. Follow-up in this group was 11±8 months.
Results: IOP decreased from 39±7 to 23±6 mmHg after von-Denffer implantation. After an Ahmed valve was implanted the IOP fell from 38±3 to 8±10 mmHg. After lasercyclodestruction the IOP was lowered from 33±8 to 18±2 mmHg.
Complications were only observed in the group with implant surgery. Especially scarring of the valve and the plate led to several revisons of the conjunctiva. Also hypotony nad phthisis occured in this group. Lasercyclodestruction had to be repeated in one patient twice and in another one three times. No other complications were observed.
Conclusion: Because implant surgery is more difficult to perform and shows more complications, it is not the first choice in most severe eye burns. Because of the lack of complications we would prefer lasercylclodestruction in these patients.
Augenklinik der RWTH Aachen, Pauwelsstr. 30, D-52057 Aachen