Bệnh tăng nhãn áp phẫu thuật được chỉ định trong trường hợp thiệt hại thần kinh glaucomatous tiến bộ quang và áp lực nội nhãn không kiểm soát được mặc dù quản lý y tế [1]. Trabeculectomy là thủ tục phẫu thuật ưa thích để có được những | Chapter 10 Glaucoma Surgery Suturing Techniques Joanna D. Lumba and Anne L. Coleman 10 Key Points Surgical Indications Trabeculectomy and drainage devices Progressive glaucomatous optic nerve damage and uncontrolled intraocular pressure Instrumentation Colibri forceps French forceps dressing forceps Straight and curved tying forceps Fine needle holder Westcott and Vannas scissors 10-0 Nylon suture 9001 G needle 7-0 Prolene suture 8-0 Vicryl J547 needle 9-0 Vicryl BV100 needle Surgical Technique Careful delicate handling of the conjunctiva Partial-thickness suture passes through sclera Complications Buttonholing of conjunctiva Piercing sclera full-thickness on passing su-t Introduction This chapter introduces the beginning surgeon and refreshes the experienced surgeon on suturing techniques used in glaucoma surgeries including trabeculectomies and drainage devices. A key tenet of glaucoma surgery is careful and delicate handling of the conjunctiva in all procedures. The following pages present descriptions of techniques used in closing the conjunctiva in both trabeculectomy and drainage device implantation. Suturing the trabeculectomy flap the drainage device and pericardial tissue donor sclera is also covered in this chapter. Surgical Indications Glaucoma surgery is indicated in cases of progressive glaucomatous optic nerve damage and uncontrolled intraocular pressure despite medical management 1 . Trabeculectomy is the preferred surgical procedure to obtain the lowest achievable intraocular pressure. However implantation of a drainage device may be chosen in cases of glaucoma secondary to neovascularization of the anterior chamber angle uveitic processes prior penetrating lamellar keratoplasty prior failed trabeculectomy or aphakia 2 . Instrumentation and Equipment As mentioned careful handling of the conjunctiva is of utmost importance in successful glaucoma surgery. Use of proper instrumentation facilitates every step of surgery. Nontoothed .
