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Paul Palmberg, MD, PhD
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Paul Palmberg, MD, PhD, demonstrates that the use of a valve-like scleral tunnel incision helps avoid early and late hypotony, and intraoperative adjustment of IOP at equilibrium flow can set the IOP at the target pressure. If hypotony occurs, cases without maculopathy can be repaired with Shirato's technique of transconjunctival suturing of the scleral flap. However, if there is hypotony maculopathy, then our two sets of scleral flap sutures can reliably reverse the maculopathy in 1 to 4 weeks and, after lysis/release of the second group of sutures, usually maintain good IOP control. If a melted scleral flap is encountered at re-operation, a scleral patch graft suspended (like an abacus bead) with two horizontal compressing sutures can reverse the maculopathy as a variant of the two sets of stitches technique.
Posted: 11/19/2024
Paul Palmberg, MD, PhD
Paul Palmberg, MD, PhD, demonstrates that the use of a valve-like scleral tunnel incision helps avoid early and late hypotony, and intraoperative adjustment of IOP at equilibrium flow can set the IOP at the target pressure. If hypotony occurs, cases without maculopathy can be repaired with Shirato's technique of transconjunctival suturing of the scleral flap. However, if there is hypotony maculopathy, then our two sets of scleral flap sutures can reliably reverse the maculopathy in 1 to 4 weeks and, after lysis/release of the second group of sutures, usually maintain good IOP control. If a melted scleral flap is encountered at re-operation, a scleral patch graft suspended (like an abacus bead) with two horizontal compressing sutures can reverse the maculopathy as a variant of the two sets of stitches technique.
Posted: 11/19/2024
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