Surgical Contraindications

A blind, painful eye is an absolute contraindication to glaucoma surgery. Because there is no visual benefit to be gained, pain control can be more safely and effectively achieved through other means. Surgery also is contraindicated for a blind, painless eye. In addition to being unable to improve vision, the clinician would be incurring a small risk of inducing sympathetic ophthalmia. Eyes with ocular neoplasms and individuals with poor hygiene should be considered poor risks for trabeculectomy; instead, noninvasive surgical therapy, such as cyclodestructive surgery, should be considered. Patients with iris neovascularization or neovascular glaucoma should be treated first with retinal ablation by panretinal photocoagulation and/or peripheral cryotherapy to induce regression of neovascularization.

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