Clinical picture glaucoma

Glaucoma surgery, cataract and glaucoma combined operation

The "Green Star" (glaucoma) is an eye in which the intraocular pressure is

increased and / or insufficient blood flow to a typical glaucoma the change
in the optic nerve in the affected eye has led.

The intraocular pressure is mainly on the water chamber. This is in the eye
Vorderabschnitt formed circulates in the anterior chamber and flows on the
so-called chamber angle and the channel Schlemm'schen

If the runoff is disturbed, dams, the water chamber inside the eye and eye
pressure rises. As the vision will not worsen, the patient noticed the
change in Sehnervenscheibe and of the visual field. Untreated, the Green
Star / glaucoma in months, sometimes in days to acute vision loss.

If a sufficient reduction of elevated intraocular pressure by medication

(for example, drops, tablets) is not possible, to glaucoma surgery. It aims
to drain the water of the chamber to improve or the board of education to
reduce water.

What happens in the operation?

The operation is under local anesthesia by injection or Tropfanästhesie a
stun means next to or behind the eyeball (Parabulbär-
/Retrobulbäranästhesie), anesthesia or a combination of anaesthesia with a
local anaesthetic.

There are several surgical procedures, they are under the operating
microscope, some even with the support of the laser. The essence are listed
below:

1st Iridektomie: In the periphery of the rainbow skin (Iris) is surgically

or with the laser created a small opening to the drainage of water above
the chamber chamber angle. The Iridektomie is occurring primarily in
acutely intraocular pressure (acute glaucoma).

2nd Filtration surgery: A new Abflussweg is under the conjunctiva by a very

small opening in the dermis, is also in this area Iris Window
(Iridektomie). This may also be separated, e.g. with a laser cutting of the
Chamber The outflow water from the front eye is thereby improved

3rd Chamber angle cut (Goniotomie, Trabekulotomie, Goniokürettage): When

congenital Green Star with a fine needle-thin knife or similar instruments,
the delicate membranes before trabecular mesh factory cut the Abflussweg
embarrassed. The outflow of water from the eyes anterior eye this section.

4th Viskokanalostomie: The operation is the chamber angle cut. In addition,

to improve the effluent a gelartiges funds in the drainage channel times.

5th Sklerektomie: The operation is the chamber angle cut. To improve the
effluent is also a piece of leather from the skin and over the drainage
channel also cut.

6th Scarring: Part of the Ziliarkörpers, the Chamber of water, healed, for
example by a cold rod (Zyklokryokoagulation) or by laser light
(Zyklophotokoagulation). This will subsequently less eyes water. This
method is common in Sekundärglaukomen, for example, as a result of
thrombosis in the eye or even with vascular changes (sugar disease).
7th Laser treatment in the chamber angle: After stunning the cornea and
setting up a contact lens, the chamber angle in selected sections
niedrigdosiertem with laser light. This procedure is preferred for low
pressure in the eye increases.

8th Valve surgery: A small tube (plastic tube) combines the anterior eye
chamber with the area outside of the eye (eye socket) and a part of the
chamber under the water is managed and conjunctiva of the eye so that
pressure.

9th Combination of filtration surgery and cataract surgery (in green and
grey Star): The modern surgical techniques make it possible, cataracts
(clouding lenses) and the Greens Star (glaucoma) to operate simultaneously.
It is the getrübte lens (cataract, cataract) over a corneal incision using
the ultrasound method evacuated (Phakoemulsifikation) and a new artificial
lens to improve vision. At the same time, or subsequently, a filtration
operation.

After surgery, the small cut on the eye with the finest seams or seamlessly
sealed. Depending on the suture material, the threads in days or weeks
away, leave or dissolve itself.

In order to improve the healing, the eye after entering an antiseptic

ointment for a few hours / days. Especially in congenital Green Star and
Sekundärglaukomen, for example, as a result of an existing eye
inflammation, thrombosis in the eye or even with vascular changes,
additional drugs are often used, a scarring of the conjunctiva prevent
(Antimetabolite: for example, mitomycin C, 5-fluorouracil). These drugs are
unique during the operation (mitomycin C) and / or more after the operation
(5-fluorouracil) locally on the eye.

Give your consent necessary or useful additions or changes to the proposed

intervention before the surgery, so that these same anaesthetic procedure
can be carried out and another surgery is avoided.

What complications and adverse effects may occur?

Glaucoma-operation (Green Star) and laser eye treatment are standard
procedures, comparable with the operation of cataract (cataract surgery).

After the operation, the Augeninndruck temporarily increase. A strong

increase (malignant glaucoma) is rare.

Fließt Chamber too much water or is a result of the operation too little
water chamber formed, it decreases the pressure in the eye and the anterior
flacht. That vision can be significantly restricted.

After filtration operation, the new operating Abflussweg occasionally

sealed.

Despite the pressure may reduce the visual field deteriorate, especially if
there is already before the operation massive visual field defects existed.

After the surgery can - mostly as a long-term impact - a lens opacity

(cataract / cataract) or develop an already consisting lens opacity faster
progress.

Permanent corneal damage are very rare, but can be very painful.

After all mentioned here complications and adverse consequences can be

repeated interference (for example, if it has not succeeded in the
intraocular pressure to reduce or increase this heavily) or operations (for
example, to the new Abflussweg after a filtration operation abzudichten or
to expand it). Such interventions clarifies your doctor / Your doctor
separately.

Also bleeding in the eye, injuries, infections and side effects of drugs,
and the central locking eyes vessels or central Sehnervgefäße result of
injections may require further surgery and very rarely lasting
Sehverschlechterung to loss of vision and the eye.

Serious adverse reactions (such as drugs, narcotics) for vital functions

(heart, circulatory, respiratory, kidney) and permanent damage (such as
organ failure, paralysis) are very rare.

Very rarely caused the stunning Lidmuskelnervs temporary Kaubeschwerden.

About specific side effects of drugs / narcotics, in the operation should

be informed your doctor / Your doctor in the education conversation.

Also preparatory, accompanying and subsequent measures (such as infusions,

anesthetic injections for pain) are not completely free of side effects and
risks.

Please ask your doctor / your doctor if you need more information.

Treatment success
The majority of patients, the increased intraocular pressure from the
operation and sufficient largely reduced. Supporting are u.U. Drugs (such
as eye drops), where the surgery later repeated.

Please note!
Before the operation
The surgeon will decide whether and when blutgerinnungshemmende drugs (such
as Marcumar ®, aspirin ®) under the supervision of the attending doctor or
sold by another drug must be replaced.

After the operation

Physical effort to avoid the operation, possibly bed rest for medical
instruction to comply.

Prescribed eye drops and / or tablets regularly.

Eye pressure checked regularly.

Please contact your doctor immediately / your doctor for a rash of eye
surgery, acute eye pain or headache and a Sehverschlechterung!

If the outpatient surgery, you must be of an adult escort picked up because

your reaction times by stunning, sedatives and / or pain medication, and
your eyesight by the intervention are still limited.

Please ask your doctor / your doctor when reconnaissance discussion after
all, what's important or unclear.