The deep sclerectomy technique was modified to enhance aqueous humor (AH) outflow via the non-trabecular pathway. A pilot study was carried out to assess its safety and effectiveness. Thirty-eight patients were under observation. After superficial scleral flap (4 × 4 mm), deep scleral layers were divided into three parts by three parallel-to-limbus incisions. Deep sclerectomy without creating a window in the Descemetes’ membrane was carried out in the distal part. A collagen implant was placed under the sclera of the remaining two parts with one end in the intrascleral pool. The third proximal part was excised to expose the uvea and implant. A Nd:YAG laser trabeculotomy at the surgery site was made on postoperative days 7–10. Outcome measures were IOP change, use of hypotensive medication(s), complications, and the need for a second surgery. At six months, the mean IOP decreased from 29.1 ± 9.2 mm Hg to 14.0 ± 4.3 mm Hg (p = 1.4 × 10−9); hypotensive medication use reduced from 2.9 ± 0.9 to 0.6 ± 1.0 (p = 1.3 × 10−10); complete success was achieved in 68.4% of cases and partial success was achieved in 31.6% of cases. Intraoperative and postoperative complications were rare and manageable. The OCT of the surgery site revealed the absence of bleb in all cases. Lymphatic vessels with characteristic bicuspid valves in their lumen were detected in conjunctiva near the operation site and over it in 32 patients. IOP decrease in the proposed technique was achieved by activation of the uveolymphatic route of AH outflow.
To study the effect of pH on the conjunctival cavity. Materials and methods. All patients underwent the following studies: Biomicroscopy of the conjunctival cavity, evaluation of the cosmetic effect of prosthetics, sensation and comfort, and bacterial culture of the discharge. The results of the study. As a result of the study, it was found that patients using ocular prostheses with concomitant diabetes mellitus have a pH shift in the conjunctival cavity to the alkaline side, which will lead to partial inflammatory reactions of the conjunctival cavity, resulting in a decrease in the desired cosmetic effect Conclusion. Diabetic patients require a lot of attention and a more thorough approach to meeting the conditions for normalizing the pH of the conjunctival cavity, and the terms of replacing the prosthesis, as a result, achieving a good cosmetic effect. K E Y w O R D S-ocular prosthetics, anophthalmia, diabetes mellitus.
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