We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 12 January 2010
Multiple ocular conditions can lead to the development of glaucoma, which is the most common optic neuropathy. All therapeutic interventions are directed towards lowering the condition's greatest risk factor, intraocular pressure.
Typically, therapy is instituted in an ascending fashion, with topical medical therapy being the first and simplest option. Medications include topical beta adrenergic blockers, prostaglandin analogs, carbonic anhydrase inhibitors, alpha adrenergic agonists, and miotics; these agents, used alone or in combination, are often sufficient for control of intraocular pressure. In cases of open angle glaucoma requiring greater management of intraocular pressure, laser trabeculoplasty, an outpatient procedure, is used in conjunction with medications. For angle closure glaucoma, outpatient laser iridotomy is applied to relieve the pupillary block mechanism.
Incisional intraocular surgery is the most frequent choice when medical and outpatient laser procedures fail to diminish intraocular pressure, with trabeculectomy and aqueous tube shunt placement being the most commonly used procedures. Both approaches lower intraocular pressure by allowing aqueous humor to leave the anterior chamber and collect in the subconjunctival space. When other interventions have either failed or are unfeasible, such cyclodestructive procedures as laser ablation or cryoablation of the ciliary processes may be done. Incisional surgery is done in an operating room, usually on an outpatient basis; cyclodestructive operations are performed in a clinic setting; and local anesthesia is standard for both methods.
Usual postoperative course
Expected postoperative hospital stay
Glaucoma surgery usually does not require hospitalization, though monocular patients undergoing incisional surgery may be hospitalized.
To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.
