terminology and guidelines for glaucoma ii - Kwaliteitskoepel

4.5 - SECONDARY ANGLE-CLOSURE GLAUCOMAS
4.5.1 - SECONDARY ANGLE-CLOSURE GLAUCOMAS WITH PUPILLARY BLOCK
Several steps may be considered, according to the clinical picture of causative mechanisms.
a) Topical and systemic IOP lowering medication
b) Nd:YAG laser iridotomy
c) Peripheral iridectomy
d) Lens extraction, vitrectomy
e) Discontinuing miotics in miotic-induced pupillary block
f) Pupillary dilation
g) Nd:YAG laser synechiolysis of posterior synechiae
4.5.2 - SECONDARY ANGLE-CLOSURE GLAUCOMAS WITH ANTERIOR “PULLING” MECHANISM WITHOUT
PUPILLARY BLOCK
4.5.2.1 - Neovascular glaucoma
a) Topical atropine or equivalent
b) Topical steroid initially
c) Topical and systemic IOP lowering medication as needed
d) Retinal ablation with laser or cryotherapy
e) Cyclodestruction
f) Filtering procedure with antimetabolites
g) Aqueous drainage devices
Miotics are contraindicated
4.5.2.2 - Iridocorneal endothelial syndrome
a) Topical and systemic IOP lowering medications as needed
b) Filtering procedure, with antimetabolite according to risk factors
c) Aqueous drainage device
4.5.2.3 - Posterior polymorphous dystrophy
a) Topical and systemic IOP lowering medication as needed
b) Filtering procedure, with antimetabolite according to risk factors
4.5.2.4 - Peripheral anterior synechiae due to prolonged primary angle-closure glaucoma
a) Topical and systemic IOP lowering medication as needed
b) Filtering procedure
4.5.2.5 - Epithelial and fibrous ingrowth after anterior segment surgery or penetrating trauma
a) Topical and systemic IOP lowering medication as needed
b) Excision, destruction of the immigrated tissue
c) Filtering procedure, with antimetabolite according to risk factors
d) Aqueous drainage device
e) Cyclodestruction
Ch. 4 - 12 EGS