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Angle Recession Glaucoma

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Surgery continued...

Although effective, trabeculectomy for angle recession glaucoma has a lower success rate when compared to POAG. Trabeculectomy in eyes with angle recession is associated with less IOP reduction after surgery, greater bleb fibrosis (scarring), higher rate of bleb failure, and greater dependence on glaucoma medications after surgery.

Drainage implant surgery

 

Drainage implant surgery can be  performed as an alternative to trabeculectomy filtration surgery or after after one or more attempts at trabeculectomy have failed.

In drainage implant surgery, the ophthalmologist places a tube in the anterior chamber to shunt the aqueous humor. Different types of implants can be used, but most function by allowing better drainage of the aqueous humor from the anterior chamber, thereby lowering IOP.

Although beneficial, drainage implant surgery may be less successful in angle recession glaucoma than in other types of glaucoma. In angle recession glaucoma caused by a traumatic event, one study reported better results using trabeculectomy with antimetabolites over drainage implant surgery.

Next Steps - Follow-up

As with other types of glaucoma, the frequency of follow-up care depends on the level of IOP control and the risk of vision loss.
 

  • If your IOP is elevated soon after a blunt trauma, you may be reexamined every 4-6 weeks during the first year to monitor your condition. Although most cases do not progress to angle recession glaucoma, you should continue to be checked even after the condition has appeared to resolve. Sometimes, the early elevation of IOP represents a severe form of the disease that may not respond to standard medical treatment. Severe forms require more frequent follow-up care.

  • In eyes with angle recession involving more than 180° of the iris but without any signs of glaucoma, the potential for late-onset glaucoma is still a reasonable concern, even many years after the injury. If you fall into this category, annual eye examinations will be performed for an indefinite period of time.

Prevention

The incidence of angle recession glaucoma could be reduced by prevention of underlying trauma. Data indicate that most eye injuries (e.g. sports-related accidents) in both adults and children are preventable.
 

  • Public education on the use of eye, face, and/or head protection during high-risk activities may lower the incidence of eye injuries.

  • Public safety standards to reduce the rates of eye injuries can be achieved by enacting legislative policies, such as seatbelt laws and helmet laws.
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