Research Article
Volume 12 Issue 8 - 2021
The Serous Choroidal Detachment After Glaucoma Surgery: Demonstration of a Pathogenic Mechanism Denied by Modern Literature
Constantin-Dan Bordeianu*
CMI Dr Bordeianu Constantin Dan, Ploiesti, Prahova, Romania
*Corresponding Author: Constantin-Dan Bordeianu, CMI Dr Bordeianu Constantin Dan, Ploiesti, Prahova, Romania.
Received: June 17, 2021; Published: July 30, 2021




Abstract

Aim: Prove a mechanism of action in postoperative serous choroidal detachment (SCD), a mechanism denied by modern literature.

Materials and Methods: Ten cases with advanced trabecular glaucomas that developed SCD: 9 cases - after Vancea trabeculectomy and 1 case - after my technique named trabeculokeratencleizis. The methodology used in this study started from a series of observations: after the drainage of SCD through a scleral puncture - practiced after 7 days of ineffective medical treatment, and after the reformation of the anterior chamber (AC) with saline through a corneal puncture, the AC rapidly disappeared in parallel with SCD fluid outflow through the scleral puncture, when it was opened. This finding suggested the existence of a direct communication between the AC and the SCD lobes. In order to demonstrate its existence, Na and K ions concentration was measured by gas chromatography in the SCD fluid collected at the first evacuation and after several suprachoroidal space washings.

Results: The Na+ concentration remained within normal limits both in the first sample and in the one collected after 3 - 6 suprachoroidal space washing cycles. The K+ concentration showed a dramatic decrease. This can be explained by the fact that the washing fluid (the saline solution) contains only Na+ and no K+.

Conclusions:

  1. In case of SCD after glaucoma surgery, a communication between AC and the supraciliary and suprachoroidal space existed in all tested cases after 7 days of athalamia/hypotony syndrome.
  2. The communication was proven in a quasi-experimental manner, by spectrophotometric dosage of Na and K ions in the SCD fluid collected before and after several suprachoroidal space washings.
  3. This communication might either be the cause of SCD or its consequence. Certainly, the presence of such communication prolongs the sickness.

 

Keywords: Serous Choroidal Detachment; Pathogenic Mechanism; Glaucoma Surgery

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Citation: Constantin-Dan Bordeianu. “The Serous Choroidal Detachment After Glaucoma Surgery: Demonstration of a Pathogenic Mechanism Denied by Modern Literature”. EC Ophthalmology 12.8 (2021): 11-23.

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