Glaucoma Surgery

Zonulopathy, cataract, and uveitic glaucoma management with phaco, capsular tension segments, and Ahmed FP-7 glaucoma drainage device placement:

This is a monocular patient with severe uveitis-related zonulopathy, posterior subcapsular cataract, and uveitic glaucoma managed with phaco, Mackool capsular hooks, Ahmed capsular tension segments placed 180 degrees apart, in-bag capsular IOL placement, and Ahmed FP7 glaucoma tube. Comments welcome.

Phacoemulsification and iStent placement:

Here is a video demonstrating phacoemulsification with iStent placement in a patient with mild glaucoma and visually significant cataract. Intraocular pressure was above target levels despite 2 IOP lowering medications. The phacofractis technique used in this case is stop-and-chop. The iStent is FDA approved for placement at the time of cataract surgery for patients with mild to moderate glaucoma. Post-operative IOP typically ends up in the mid to high teens, often on fewer medications than pre-op.

Cyclodialysis cleft closure:

This video summarizes the management of a difficult case of persistent hypotony maculopathy related to a large cyclodialysis cleft (10 clock hours!) after severe blunt trauma. The cleft proved refractory to pharmacologoc mydriasis and laser cyclopexy.

Occassionally we work to increase the pressure in eyes!