Goniopuncture

Goniopuncture is a rarely performed surgical procedure for congenital glaucoma, the purpose of which is to improve the outflow of intraocular fluid from the eyeball.

During the operation, using a thin scalpel, an incision is made inside the eye in the area of ​​Schlemm's canal, which is located at the junction of the cornea and sclera. The incision continues until the tip of the scalpel appears under the conjunctiva. This creates an additional path for the outflow of intraocular fluid from the anterior chamber of the eye under the conjunctiva.

The doctor monitors the movement of the tip of the scalpel through special contact lenses that allow one to see the deep structures of the eye.

Goniopuncture: what is it and how does it help with congenital glaucoma?

Congenital glaucoma is an eye disease characterized by increased intraocular pressure, which can lead to poor vision and even blindness. Goniopuncture is one of the operations that can be performed to improve the outflow of fluid from the eyeball and reduce intraocular pressure.

Goniopuncture surgery is rarely performed and is usually only done when other treatments have failed. In this operation, an incision is made in Schlemm's canal, which is the cavity at the junction of the cornea and sclera, using a thin scalpel. The incision continues until the tip of the scalpel appears under the conjunctiva. Thus, an additional path is created for drainage of fluid from the anterior chamber of the eye under the conjunctiva.

Special contact lenses help the doctor follow the tip of the scalpel inside the eye. The operation is performed under local anesthesia and usually takes no more than 10-15 minutes.

After goniopuncture surgery, there may be bleeding and swelling in the eye area, but this usually goes away after a few days. The patient may be prescribed eye drops to help reduce intraocular pressure and prevent infections.

Although goniopuncture can help improve fluid drainage from the eyeball and reduce intraocular pressure, it is not always effective. In addition, like any operation, goniopuncture may have risks and complications. Therefore, before deciding to undergo this operation, you need to discuss it with your doctor and weigh all its advantages and disadvantages.

Goniopuncture surgery: what is it?

One of the modern methods of treating glaucoma is goniopuncture intervention. This procedure involves surgical intervention into the vitreous cavity, in the area of ​​Schlemm's canal, during which an additional hole (window) is opened to reduce the amount of moisture (fluid) in the eye. Essentially, temporary and minimally invasive drainage of intraocular fluid occurs.

In what cases is it prescribed? Indications for this event are:

the appearance of proteopes (“flakes” and threads) inside the vitreous opening; progressive development of glaucomatous optic nerve atrophy (a thin strip of tissue in the area of ​​the nerve of the head, the visual retina is under pressure); increase in diameter of the excavation angle. With such clinical pictures, goniopuncture is considered an effective preventive measure that prevents complete or partial loss of vision, and occupies a separate place among therapeutic techniques. Principle of operation The essence of this operation is to dissect the cavity of the glassy gel in the gap between the mucous membrane of the conjunctiva and the cornea using a special long metal needle. This gap is localized at the convergence of the pupil and lens

**Goniopuncture** is a method of treating refractive-type eye diseases, as well as eliminating the consequences of injuries, decompensated cataracts, and glaucoma. The operation is performed in order to improve the outflow of intraocular fluid.

The operation was invented by the American ophthalmologist Mohr in 1983. The essence of the method is to create an additional path for removing fluid that accumulates in the anterior chamber - the physiological depression between the iris (cornea) and the front surface of the lens.

**Goniopuncture is done in the following cases:**

* Presence of decompensated glaucoma (high pressure, complicated damage to the optic nerve). For example, if a person with open-angle glaucoma has an increase in the level of intraocular pressure relative to the standard value that exceeds the normal value, then this pathology must be treated. This is especially true for elderly patients and those with concomitant cardiovascular, renal and endocrine diseases, for whom high blood pressure is a fatal complication. * Eye injury caused by a blow or bruise to the cornea, especially with damage to the nucleus when it is pressed into the eye. The liquid, which is separated, closes the fossa of the anterior chamber and impregnates the internal shells of the optical system. These changes lead to decreased visual acuity, the appearance of fog in the eyes and photopsia. Swelling of the lens (pseudophakitis) with loss of transparency is often observed. But vision can be restored because the optical system of the eye is rarely seriously damaged. To do this, it is necessary to use a special mode with positional micropulses, electric current stimulation or laser stimulation. If the effectiveness of pharmacological drugs