By Erna E. Kritzinger
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Additional info for A Colour Atlas of Optic Disc Abnormalities
2012b). 38 K. Hu et al. Practical Tip: Trans-trabecular Meshwork Surgeries • Anterior vitrectomy should be performed if there is any chance of vitreous loss into the AC from previous surgery. Positioning of head of patient and tilting the microscope are essential for good visualization. • Blood reflux into the anterior chamber is NOT a complication, it simply signals a direct communication between the anterior chamber and collectors had been established. • Membrane formation covering the inlets of iStent & Hydrus as well as exposed collector channels after Trabectome surgery may benefit from YAG laser disruption.
But, due to the dual action of the Hydrus implant, which bypasses the trabecular meshwork and expands the Schlemm’s canal thus giving access to multiple collector channels, it is possible that the IOP reduction could be higher than after iStent implantation. However, this higher efficacy has still to be established. 3 Complications Reported complication rate is very low, and when performed in combination with phacoemulsification the rate is similar to a cataract alone procedure (Pfeiffer et al.
Secondary glaucoma surgery was required in 2 % of the treatment group versus 4 % of the control group, and the difference was not statistically significant. 2 Patient Selection and Procedure The Hydrus implant is an 8 mm crescent-shaped implantable device. The implant is very flexible, made from nitinol (a nickel/titanium alloy), and is preloaded onto a 2 Minimally Invasive Glaucoma Surgery 29 handheld delivery system. The device not only bypasses the trabecular meshwork but scaffolds and dilates the Schlemm’s canal.