[Clinical method of the evaluation of postoperative scarring and preventive cytostatic therapy after glaucoma surgery].
Lymph microcirculation in the bulbar conjunctiva at the site of surgery was studied by fluorescent lymphangiography in 217 patients with primary glaucoma before and in various periods after trabeculectomy. Lymph vessels are changed after the operation; the pattern and intensity of these changes reflect the activity of cicatrization at the site of the operation and are closely related with the hypotensive effect in remote periods postoperation. In cases with the complete compensation of ophthalmic tone without extra hypotensive therapy a moderate narrowing of the lymph vessels was observed, parallelled by a compensatory increase of their quantity and of the volumic rate of the lymph flow. If the hypotensive effect of surgery was insufficient, an essential decrease of all the lymph flow parameters was observed, the most manifest in the patients with intraocular pressure still increased after extra drug therapy. A regular lowering of the lymph flow in 2-4 years after surgery was recorded; this lowering anticipated the deterioration of the hydrodynamic parameters. Noteworthy that ophthalmic tone failed to normalize when the mean diameter of the lymph vessels decreased more than twofold vs. the preoperative value. A conclusion is made that fluorescent lymphangiography holds good promise as a method for the assessment of the intensity of cicatrization processes after antiglaucoma surgery in order to timely prescribe preventive anticicatricial therapy. Administration of cytostatics in the postoperative period helps considerably increase the number of satisfactory outcomes of surgery due to suppression of cicatrization processes at the site of intervention. A lesser rate and intensity of cicatricial deformations of the lymph vessels was recorded in the patients administered cytostatics.
Alekseev
B N
BN
Shmyreva
V F
VF
Polutornov
A L
AL
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002921:Cicatrix / Q000175:diagnosis / Q000517:prevention & control*; D005069:Evaluation Studies as Topic; D005452:Fluoresceins; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D008208:Lymphatic System / Q000502:physiology; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D011447:Prospidium / Q000627:therapeutic use; D013997:Time Factors; D014130:Trabeculectomy
D000970:Antineoplastic Agents; D005452:Fluoresceins; D011447:Prospidium; D005472:Fluorouracil
Klinicheskiĭ sposob otsenki posleoperatsionnogo rubtsevaniia i preventivnaia terapiia tsitostatikami posle antiglaukomatoznykh operatsiĭ.