Research Article
Volume 13 Issue 1 - 2022
The Filtering Puncture - A New Surgical Procedure in Postoperative Serous Choroidal Detachment
Bordeianu Constantin-Dan*
Ploiesti, Prahova county, Romania
*Corresponding Author: Bordeianu Constantin-Dan, 15, Cameliei st, Bl 26, App 26, Ploiesti, Prahova county, Romania.
Received: December 01, 2021; Published: December 29, 2021




Abstract

Purpose: To suggest a new manner of performing the scleral puncture (the filtering puncture) in serous choroidal detachment (SCD) after glaucoma (G) surgery. This procedure is based on a pathogenic mechanism denied by modern literature: the aqueous humor (AH) migration through cyclodialysis slit or pores.

Method: After conjunctiva incision and anterior chamber (AC) filling with saline, a 3 mm long sclera incision is practiced at 4 mm from the limbus by a knife in pars planum above both SCD lobes, at 5 and 7 o’clock. If the AC flattens in parallel with fluid egress through the scleral puncture, when opened, a second, perpendicular, 3 mm long incision is practiced at one end of the puncture and the scleral corner thus delineated is excised. The AC is reformed with air until the iris/lens diaphragm is slightly concave. Conjunctiva suture.

Material: 12 consecutive cases between 1984-1987 with postoperative SCD resisting to the conservative attitude underwent the new procedure 7 days after external drainage G surgery (Vancea trabeculectomy-7 cases, Cairns trabeculectomy-3 cases, trabeculokeratencleizis-2 cases). For each case, two filtering punctures were practiced (infero-internal and infero-external), because the simple puncture produced fluid egress in both sectors.

Results: The AC was normal from the first postoperative day, with the air bubble freely floating in AH in all cases. The bed rest and binocular patch ceased immediately and the patient left the hospital the following day. No case relapsed. The inferior conjunctiva remained raised by a flat filtering bleb for the next 3-7 days. For comparison, from the previous 25 cases when I practiced the nonfiltering punctures (by blade or diathermy), 7 cases (28%) needed a second puncture, and from these, 2 cases needed a third puncture (28.57%). With one exception, each puncture was practiced after 7 days of failed medical treatment. No external sign of filtration was observed in the conjunctiva covering the nonfiltering punctures.

Keywords: Filtering Puncture; SCD; Trabeculectomy; SEDPea; Athalamia

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Citation: Bordeianu Constantin-Dan. “The Filtering Puncture - A New Surgical Procedure in Postoperative Serous Choroidal Detachment”. EC Ophthalmology 13.1 (2022): 09-23.

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