Preoperative prevention of bleeding in antiglaucoma interventions

Relevance Glaucoma surgery, like any other, can be complicated by bleeding during the procedure [1, 2]. Correct and timely administration of vasoconstrictor therapy in preparation for surgery and in the postoperative period can reduce the risk of bleeding during and after surgery [3]. Objective To evaluate the effectiveness of preoperative use of vasoconstrictor drugs on the severity of conjunctival hyperemia and the risk of hemorrhagic complications in the early postoperative period. Material and methods A non-penetrating antiglaucoma surgery was performed in a group of 30 patients (30 eyes) with uncompensated primary open-angle glaucoma. The first group of patients - 15 people (15 eyes), who used a vasoconstrictor in the preoperative period (1 day before surgery). The frequency of instillation was twice a day. The second group of patients included 15 people (15 eyes) who did not use additional local medications in the preoperative period. The effectiveness of preoperative use of the drug was assessed by the duration of vascular coagulation during surgery. A comparative assessment of the level of intraocular pressure and the severity of conjunctival injection before and after surgery was made. The incidence of hemorrhagic complications in the early postoperative period in the patient groups was also taken into account. Results In both groups of patients, surgical normalization of intraocular pressure was observed without significant differences. When comparing the severity of conjunctival hyperemia in the postoperative period, the best result was in the first group. The duration of vascular coagulation differed: in the first group of patients it was 3.8 ± 2.6, in the second group - 6.9 ± 3. A decrease in the incidence of hemorrhagic complications after surgery was also noted in the group of patients. Conclusion The use of a vasoconstrictor as a preoperative preparation contributed to a decrease in the severity of conjunctival hyperemia after eye surgery. This in turn reduces the risk of hemorrhagic complications. Preoperative use of the drug is justified not only in antiglaucoma interventions, but also in other eye surgeries with a high risk of intraoperative bleeding [4, 5]. Keywords: glaucoma; bleeding; glaucoma surgery