URETEROSCOPIC COMPLICATIONS - PREVENTION AND MANAGEMENT

Deepraj S. Bhandarkar

Avinash N. Katara

Gaurav Mittal

Rasik Shah

Tehemton E. Udwadia

ELLISON, FC

FABRI, PJ

GUYTON, JS

Joaquin Barraquer

separated and facilitate the formation of a filtering bleb

which is usually diffuse and not very prominent.In the prevention and management of postoperative complications

especially ciliary block or malignant glaucoma

Healon has been found to be extremely useful. Careful suturing of the scleral pening

reformation of the anterior chamber with Healon and instillation of 1% atropine to produce adequate relaxation of the ciliary body

and the administration of local and general corticosteroids to inhibit the inflammatory reaction are imperative to avoid these complications. If

in spite of all precautions

ciliary block glaucoma does occur

osmotherapy must be started immediately intravenous mannitol

or

preferably

lyophilized urea

the pupil must be dilated using 4% atropine and 10% phenylephrine

and the doses of corticosteroids should be increased 60 mg. of prednisone in intramuscular injection and frequent instillation of dexamethasone eye drops. If the problem does not resolve within a few hours

immediate reintervention is imperative:1 Posterior sclerotomy at the level of the pars plana ciliaris.2 Vitrectomy and aspiration of the aqueous humor which is retained behind and/or in the vitreous humor.3 Reformation of the anterior chamber with Healon.4 The pupil should be maintained dilated with 4% atropine during a prolonged period of time. Prof. Joaquin Barraquer M.D.

F.A.C.S. Instituto Barraquer Barcelona

Spain

Gollwitzer, H.

Gradinger, R.

Miller, Travis J.

Lavin, Christopher V.

Momeni, Arash

Wan, Derrick C.

Antonelli, Patrick J.

WARREN, KW

FIELDS, H

Kuhar, Hannah N.

Nesemeier, Ryan

Kim, Leslie R.