Expulsive Hemorrhage After Glaucoma Filtering Surgery

Jirásková, N; Rozsíval, P; Pozlerová, J; Ludvíková, M; M, Burova

doi:10.5507/bp.2009.038

Cited by 10 publications

(17 citation statements)

References 18 publications

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“…Bu sistemik ve oküler koşulların siliyer arterlerin bütünlüğünü zayıflattığı düşünülmektedir. 12 Postoperatif dönemde öksürme, mide bulantısı, kusma ve valsalva sonucu episkleral venöz basıncın artması ile siliyer arter duvarı boyunca artan bir basınç gradientine neden olmakta ve SKH riski yükselmektedir. Fakoemülsifikasyon cerrahisinde SKH insidansı %0,03-0,13 arasında bildirilmiştir.…”

Section: Discussionunclassified

A Rare Complication Secondary to Traumatic Wound Dehiscence After Penetrating Keratoplasty: Suprachoroidal Hemorrhage

Dursun¹,

Şekeroğlu²,

Ileri³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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ara yeri ayrılması, penetran keratoplasti (PKP) sonrasında ortaya çıkabilen ciddi bir komplikasyondur. Bu komplikasyonun ortaya çıkmasındaki en önemli sebeplerden biri travma olsa da yara ayrılmasının diğer muhtemel sebepleri arasında enfeksiyöz keratit, sütür komplikasyonları ve sütür alımı sonrası spontan ayrılmalar sayılabilmektedir. 1 Yara ayrılması sonucu intraoküler lens dislokasyonu, koroidal hemoraji, endoftalmi, vitreus kaybı, glokom ve retina dekolmanı gibi pek çok ikincil komplikasyon ortaya çıkabilmektedir. Suprakoroidal hemoraji (SKH), intraoküler cerrahilerin herhangi bir aşamasında meydana gelebilen, zamanında fark edilmez ve acilen müda

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Section: Discussionunclassified

A Rare Complication Secondary to Traumatic Wound Dehiscence After Penetrating Keratoplasty: Suprachoroidal Hemorrhage

Dursun¹,

Şekeroğlu²,

Ileri³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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“…SCH could be divided into different cathegories, according to the character of the fluid into serous and haemorrhagic; by the time of occurrence in relation to the surgery into peroperative and postoperative. Diagnosis is based on biomicroscopic and ultrasound ÚVOD Suprachoroideální hemoragie (SCH), neboli krvácení mezi cévnatkou a sklérou, patří k obávaným a závažným komplikacím nitroočních výkonů [3,4,8]. Vzhledem k velmi nepříznivé prognóze stran vidění je zcela zásadní včasná diagnóza a léčba [3,8].…”

Section: Suprachoroideal Haemorrhage In Postoperative Period Of Antigunclassified

“…Se SCH se můžeme setkat peroperačně či po operacích šedého zákalu, perforujících keratoplastikách, trabekulektomiích nebo také u pars plana vitrektomií [3,4]. SCH můžeme rozdělit podle velikosti, SCH menšího rozsahu bývají zpravidla benigní, nazýváme je suprachoroideální hematomy [3], masivní SCH, tedy stavy, kdy se protilehlé části sítnice dostávají do apozice, se označují také "líbající se ablace choroidey" [6].…”

Section: Suprachoroideal Haemorrhage In Postoperative Period Of Antigunclassified

“…SCH můžeme rozdělit podle velikosti, SCH menšího rozsahu bývají zpravidla benigní, nazýváme je suprachoroideální hematomy [3], masivní SCH, tedy stavy, kdy se protilehlé části sítnice dostávají do apozice, se označují také "líbající se ablace choroidey" [6]. SCH vzniklé v souvislosti s nitroočním zákrokem rozdělujeme na peroperační a pooperační, nebo-li pozdní [3,4]. Rozsáhlé peroperační SCH jsou označovány také jako expulsivní pro jejich rychlý nástup a velký rozsah [3].…”

Section: Suprachoroideal Haemorrhage In Postoperative Period Of Antigunclassified

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Suprachoroidal Haemorrhage in Postoperative Period of Antiglaucoma Surgery, Case Report

Středová

Hejsek

Nekolová

et al. 2019

CSO

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Suprachoroidal haemorrhage (SCH) is a serious complication of intraocular procedures. Physiologically there is only a minimal amount of fluid in the suprachoroid space, pathologically the fluid volume increases, which causes ablation of the choroid. SCH could be divided into different cathegories, according to the character of the fluid into serous and haemorrhagic; by the time of occurrence in relation to the surgery into peroperative and postoperative. Diagnosis is based on biomicroscopic and ultrasound examinations. The ocular risk factors for SCH are glaucoma, myopia and aphakia; systemic risk factors include vascular fragility, arterial hypertension and blood coagulation disorders. In the pathogenesis hypotonia of the eye, that causes rupture of the ciliary vessels, plays a very important role. SCH can be treated both conservatively and surgically. As to pharmacotherapy we use gabapentin to suppress neuropathic pain and prednisone, topical mydriatics and anti-inflammatory agents. The type of surgical treatment differs according to time of occurrence, if SCH occurs during the operation, the intervention consists mainly in the wound closure and the repositioning of the weakening tissues; in postoperative forms, we choose drainage procedures, possibly vitreoretinal procedures. Our patient, an 80-year-old myop and chronic glaucomatic treated intensively both topically and systematically underwent trabeculectomy on his left eye due to unsatisfactory intraocular pressure (IOP) and significant glaucoma progression. The surgical intervention went without any complications. In the early post-operative period, there was persisting elevation of IOP, therefore sclera lap was discontinued and 5-fluorouracil was applied under the filter blister. Subsequent hypotonia caused a hemorrhagic SCH with intraocular hypertension, which was resolved by draining the blood with sclerotomias and thus releasing intraocular hypertension. The visual acuity of the left eye gradually improved to almost original values. Intraocular pressure, however, is not well compensated despite many following antiglaucoma surgeries. Therefore, even with the patient‘s maximum therapy, glaucoma continues to progress. In our case, we confirm that it is possible to solve even the relatively most complicated cases of SCH. We stress the necessity to consider the presence of risk factors of the occurrence of SCH before indicating intraocular procedures and also recommend thinking carefully about other less invasive surgical techniques. In glaucoma, it is appropriate taking in account the prediction of life compared to the expected rate of progression of vision loss.

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“…7 However, the surgical procedures are also associated with relapse due to continued production and deposition of exfoliative material, and involve the risk of surgical complications. 8,9 Hence, in treating XFS glaucoma, there is a need for treating the underlying primary cause. Figure 1 summarizes the causes that predispose a person toward developing XFS.…”

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Potential Drug Delivery Approaches for XFS-associated and XFS-associated Glaucoma

Kulkarni

Kompella²

2014

Journal of Glaucoma

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Key tissue targets in treating exfoliation syndrome (XFS) and the associated glaucoma include lens, iris, and ciliary body, which produce the exfoliative material, and the trabecular meshwork, which may be impaired by the exfoliative material. In addition to antiglaucoma drug therapy, strategies for treating the disease include approaches for preventing formation of exfoliative material as well as those aimed at digesting exfoliative material. A variety of drug molecules including small molecules, protein drugs, and nucleic acids are potential candidates for treating XFS. Potential drug classes include antioxidants, lysyl oxidase-like 1 enhancers, antifibrotics, anti-inflammatory agents, proteases, and chaperones. However, the delivery of these agents to the target tissues in the anterior segment is hindered by protective static and dynamic barriers of the eye. Thus, unique drug delivery approaches are needed for each drug type (small molecules, proteins, and nucleic acids). In addition, there is a need for sustaining drug therapy for treating XFS, which can potentially be addressed by using nanoparticles, microparticles, implants, and contact lens delivery systems. This article provides an overview of drug delivery challenges and opportunities in treating XFS with the focus being on nanomedicines.

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Expulsive Hemorrhage After Glaucoma Filtering Surgery

Cited by 10 publications

References 18 publications

A Rare Complication Secondary to Traumatic Wound Dehiscence After Penetrating Keratoplasty: Suprachoroidal Hemorrhage

A Rare Complication Secondary to Traumatic Wound Dehiscence After Penetrating Keratoplasty: Suprachoroidal Hemorrhage

Suprachoroidal Haemorrhage in Postoperative Period of Antiglaucoma Surgery, Case Report

Potential Drug Delivery Approaches for XFS-associated and XFS-associated Glaucoma

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