Name of the Procedure:

Severing Adhesions of Anterior Segment of Eye, Incisional Technique (with or without Injection of Air or Liquid) (Separate Procedure); Goniosynechiae

Summary

This procedure involves making small incisions to carefully cut and remove adhesions (scar tissue) in the front part of the eye. It may include the injection of air or liquid to aid in the process. The aim is to treat goniosynechiae, which are adhesions between the iris and the trabecular meshwork.

Purpose

This procedure is intended to treat and manage goniosynechiae—a condition where adhesions form between the iris and the drainage angle of the eye. The goals are to improve the fluid drainage in the eye, reduce intraocular pressure, and prevent or alleviate glaucoma.

Indications

• Patients with goniosynechiae identified through eye examination.
• Persistent elevated intraocular pressure not controlled by medication.
• Visual field changes or other signs of optic nerve damage due to glaucoma.

Preparation

• Fasting may be required for several hours before the procedure, especially if sedation is planned.
• Patients should review their current medications with their doctor, as some may need to be paused.
• A comprehensive eye examination and imaging tests may be performed to assess the extent of the adhesions.

Procedure Description

1. The patient is administered local anesthesia to numb the eye.
2. A small incision is made in the cornea.
3. Surgical instruments are used to carefully cut and sever the adhesions.
4. In some cases, air or liquid is injected to aid in separating the adhesions.
5. The procedure may be performed using a surgical microscope for precision.
6. The incision is usually self-sealing but may be closed with tiny stitches if necessary.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Generally performed in an outpatient surgical center or hospital ophthalmology clinic.

Personnel

• Ophthalmologist (Eye Surgeon)
• Surgical Nurse
• Anesthesiologist or Nurse Anesthetist (if sedation is used)

Risks and Complications

• Infection
• Bleeding
• Damage to eye structures
• Prolonged elevated intraocular pressure
• Need for additional surgeries

Benefits

• Improved fluid drainage in the eye
• Reduced intraocular pressure
• Prevention or relief of glaucoma symptoms
• Preservation of vision

Recovery

• Patients may need to wear an eye patch temporarily.
• Use prescribed eye drops to prevent infection and inflammation.
• Avoid strenuous activities for at least a week.
• Follow-up appointments are crucial to monitor recovery and eye pressure.

Alternatives

• Medication to control intraocular pressure (e.g., eye drops, oral medications)
• Laser therapy (e.g., laser peripheral iridotomy)
• Other surgical options (e.g., trabeculectomy, glaucoma drainage devices)

Patient Experience

During the procedure, the patient may feel slight pressure but no pain due to local anesthesia. Post-operatively, there may be mild discomfort, which can be managed with pain relievers. Clearer vision and reduced pressure in the eye should be noticeable within days to weeks following the procedure.