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5 Complications in Glaucoma Surgery Residents Should Know

Jul 18, 2024 | Optometry

Summary

By understanding the range of complications in glaucoma surgery that residents should know, you can spot the signs of an adverse outcome before it gets worse.

An ophthalmic surgeon wearing gloves looks at a patient's eye through a surgical microscope while performing surgery.

When performing glaucoma surgery, it’s crucial to understand the potential risks involved. By understanding the range of complications in glaucoma surgery that residents should know, you can spot the signs of an adverse outcome before it gets worse. We’ll highlight the key complications that all ophthalmology students and medical residents should be aware of.

1. Bleb-Related Complications

During a common glaucoma surgery called a trabeculectomy, a surgeon makes an incision called a bleb to release excess fluid from the eye and decrease the pressure. Bleb formation is integral to many glaucoma surgeries, but it can lead to issues such as bleb leaks, infections, and scarring. Residents need to monitor for signs of bleb-related complications, including redness, pain, and vision changes. Early detection and management are key to preventing serious eye infections like endophthalmitis.

2. Hypotony and Maculopathy

Hypotony occurs when intraocular pressure (IOP) drops too low post-surgery, leading to vision-threatening conditions like maculopathy. Symptoms include blurred vision and visual field loss. Residents should aim to maintain an optimal IOP and be vigilant for signs of hypotony, especially in the first few weeks after surgery. Monitor eye pressure using a tonometer at follow-up appointments. Revised suture techniques can help mitigate this risk.

3. Overfiltration and Choroidal Effusions

Overfiltration can cause choroidal effusions, in which fluid accumulates in the suprachoroidal space. This results in eye pain and decreased vision. Prompt identification and treatment are essential to prevent long-term damage. Techniques such as careful surgical planning and postoperative adjustments can help manage overfiltration effectively.

4. Wound Leaks and Endophthalmitis

Wound leaks pose a significant risk for infections. Signs of wound leaks include fluid leakage from the surgical site, decreased IOP, and inflammation. Residents should employ meticulous surgical techniques to minimize the risk of leaks. Early intervention, including wound revision and antibiotic therapy, is critical if a leak develops.

5. Strabismus and Diplopia

Strabismus and diplopia may arise due to changes in the ocular structure post-surgery. Patients might experience double vision or misalignment of the eyes. These complications can be distressing for patients and challenging to manage. Residents should consider strabismus surgery or prism glasses as potential treatments and provide patients with appropriate counseling and follow-up care.

Once you understand the complications in glaucoma surgery that residents should know, you’ll have the knowledge to effectively manage and mitigate risks. By being aware of these potential issues, healthcare professionals can improve surgical outcomes and ensure better patient care. Always remain vigilant, employ best practices, and seek guidance from experienced colleagues. At Automated Ophthalmics, we manufacture Tono-Pen tips in the US, so you’ll never worry about a backorder delaying patient care.