HIGHLIGHTS FROM THE 2010 SAGS CONGRESS
Alpine Heath Resort, Drakensberg, 28 - 30 May 2010
In the surgical treatment of Childhood Glaucoma, the first chance is the best chance and the right choice of surgical procedure is crucial.
Congenital glaucoma surgery results in 94 of cases after surgery with IOPs under 21mmHg, but 60% need topical medication.
Children on topical treatment for congenital glaucoma need naso-lacrinal occlusion because of high susceptibility to side effects.
Modulation of scarring after drainage surgery is the major determinant of IOP after surgery.
Phaco-emulsification after drainage surgery causes prolonged aqueous flare levels which need steroid treatment to prevent drainage failure.
A red eye after drainage surgery is a risk factor for failure.
Wound healing is prolonged and complex, treatment needs to prevent early scarring and address reversibility of scarring.
Anti-metabolites do not cause hypotony, but the surgical technique does! The surgeon needs to change the surgical technique
Use an air bubble for terminal glaucoma during filtration surgery. Air is 200x more compressable than water.
Do not set expectations pre-operatively, tell the patient of possible visual loss, complications due to filtering surgery. The patient needs to worry.
A single application of 5-FU 50mg/ml/5minutes significantly improves surgical survival for more than 5 years after surgery.
No patient progressed with IOPs consistently 14mmHg and under.
Novel anti-scarring compounds and drug delivery systems like the matrix-metall-proteinase enzyme inhibitor tablet releases a drug at therapeutic levels for over 30 days.
Avastin solution versus tablet release: the tablet release rate is at least 70x longer.
A cross-sectional study of black, white and coloured South Africans revealed a statistically significant difference between the ethnic groups, which needs adjusting glaucoma management practice.