CLASSIFICATION ULTRABIOMICROSCOPIC CRITERIA OF VALIDITY OF INTRAOCULAR FLUID OUTFLOW PATHWAYS AFTER FISTULIZING ANTIGLAUCOMATOUS SURGERY

Abstract

The objective assessment of status of intraocular fluid outflow pathways afterfistulizing antiglaucomatous surgery is a necessary efficacy prediction component of glaucoma surgery. Based on complex assessment of operative zone, including ultrasound biomicroscopy, at different dates after non-penetrating deep sclerotomy the attempt of development of clinical classification of fluid outflow pathways was made. The basis of this classification is sign of morphological heterogeneity of the examined structures. In the study the parameters of the functional state of the trabeculae-Descemet's membrane were determined: the height 0.8 ± 0.09 mm, thickness 0.09 ± 0.004 mm and acoustic density < 55 ± 10 %; timelines of sclerosis -1-1.5 months after surgery. This was the rationale for the principle of a two-stage non-penetrating deep sclerectomy and indication for laser descemetogoniopuncture in terms of 1-1.5 months after the operation in the absolute number of cases. Postoperative UBM monitoring allowed determining the period of active remodeling of newly formed intraocularfluid outflow pathways in norm and their pathological formation - 6 months after the intervention. Developed system of assessment of surgically formed fluid outflow pathways by proposed method allows monitor dynamics of fluid outflow pathways forming, standardize results and determine choice of further treatment.

Keywords

• ultrasound biomicroscopy
• classification of the intraocular fluid outflow pathways
• non-penetrating deep sclerectomy
• yag-laser goniopuncture