VST Center for Glaucoma Care, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2020 Mar;68(3):420-426. doi: 10.4103/ijo.IJO_638_19.
Glaucoma management during pregnancy is a challenge for the patient and doctor. During pregnancy, the intraocular pressure (IOP) decreases. However, some women with preexisting glaucoma have elevated IOP requiring enhanced medical treatment. Glaucoma refractory to medical treatment combined with disease progression may necessitate laser trabeculoplasty or surgical intervention. Surgery during pregnancy has potential risks for both the mother and fetus. The challenges include problems with anesthesia, positioning for surgery, difficulties in the surgical procedure, potential risk with antimetabolites, and concerns with the management of postoperative complications. We report two case scenarios that highlight the challenges associated with trabeculectomy in pregnant women and the modifications that can be adopted to improve safety and the efficacy of glaucoma filtering surgery during pregnancy.
孕期的青光眼管理对患者和医生都是一个挑战。怀孕期间，眼内压（IOP）会降低。然而，一些患有青光眼的女性IOP 升高，需要加强药物治疗。对于药物治疗无效且疾病进展的青光眼，可能需要进行激光小梁成形术或手术干预。孕期手术对母亲和胎儿都有潜在风险。这些挑战包括麻醉问题、手术体位、手术过程中的困难、抗代谢药物的潜在风险以及对术后并发症管理的担忧。我们报告了两个病例，突出了在孕妇中进行小梁切除术所面临的挑战，以及可以采用的改进措施，以提高青光眼滤过性手术在孕期的安全性和疗效。
