Utilidad de la iridoplastia

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Utilidad de la Iridoplastia
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Transcripción de la presentación:

Utilidad de la iridoplastia en GCAP Dr. Jordi Loscos Arenas Hospital Universitari Germans Trias i Pujol, Barcelona 1

Utilidad de la iridoplastia en GCAP Corectopia Utilidad de la iridoplastia en GCAP Dr. P. Romera Glaucoma Consultant DO J. Castellvi Optometrist Dr S Grixolli Resident 4th year

Mecanismos de Glaucoma por Cierre Angular Primario Corectopia Mecanismos de Glaucoma por Cierre Angular Primario _Bloqueo Pupilar _Desplazamiento anterior del cristalino _Iris Plateau Iridotomía Iridotomia resuelve normalmente el componente de bloqueo pupilar 19.4 a 42.9 % Persisten mecanismos cierre angular

Iridotomía Periférica Corectopia Iridotomía Periférica Pre IP Post IP Paciente con camara estrecha dilatado post Iridotomia Fotos Guadalupe Luna

Iridotomía Periférica Corectopia Iridotomía Periférica Pre IOP Post IP p ACD 2.13±0.3 2.16±0.3 0.702 LV 823±349 777±280 0.564 A750 0.289±0.14 0.292±0.13 0.451 α 21.7±10.4 23.7±9.8 0.937 Cambio morfológico de la cámara anterior y pérdida endotelial tras IP láser YAG Drs.A Moll, Anglada, Romanic, Carbonell

Utilidad de la iridoplastia en GCAP Corectopia Utilidad de la iridoplastia en GCAP Articulos que proponen IDPL e Iridotomia

Tecnica Corectopia Anatomia Patologica La OCT no puede distinguier entre un cierre aposicional de uno sinequial

Técnica Corectopia Lente de goldman , lente de abraham Ajustar los parametros despues de cada impacto Ojo claros mas potencia / Ojos obscuros menos 6-8 impactos por cuadrante Son infrecuentes los picos HTO, muy leve inflamación

Corectopia Dinámica del iris Dinamica del iris

Corectopia Tecnica IPL + Iridotomia Iridoplastia Iridotomía

Complicaciones : Corectopía Corectopia Complicaciones : Corectopía

Utilidad de la iridoplastia en GCAP Corectopia Utilidad de la iridoplastia en GCAP Laser and Medical Treatment of Primary Angle Closure Glaucoma Laser iridotomy should be performed in all eyes with an acute episode of angle closure, the contralateral fellow of all such eyes, and in eyes with established angle closure causing raised intraocular pressure and/or peripheral anterior synechiae. Eyes with anatomically narrow angles and typical symptoms of angle closure should also be treated. Consideration can be given to laser iridotomy in eyes with iridotrabecular apposition. Iridoplasty can be considered in eyes with residual appositional closure provided a patent iridotomy is present. • Medical treatment should not be used as a substitute for laser iridotomy or surgical iridectomy in patients with PAC or PACG. Iridoplasty is as effective as pressure lowering medication in controlling intraocular pressure in people with an acute attack of angle closure. Iridoplasty is successful in relieving appositional closure due to plateau iris configuration in asymptomatic cases. Comment: Additional data in larger numbers of patients are needed. Comment: Iridoplasty may also have a role in managing cases of phacomorphic and pseudo-plateau iris configuration caused by iris cysts. http://www.worldglaucoma.org/consensus-3/#surgical

Utilidad de la iridoplastia en GCAP : Conclusiones Corectopia Utilidad de la iridoplastia en GCAP : Conclusiones _ Iridotomia e Iridoplastia resultan utiles en el GACP _ En determinados casos una opción pudiera ser mejor que otra _ Bloqueo pupilar: IRIDOTOMIA _ Apertura Angular: IRIDOPLASTIA _ Pueden considerarse ambas _ Contraindicaciones

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