Non-penetrating deep sclerectomy and collagen implant surgery in glaucoma patients with advanced field loss.

Journal: International Ophthalmology
Published:
Abstract

Objective: The aim of the study was to determine the medium term intraocular pressure (IOP) lowering effects and the potential complications of non-penetrating deep sclerectomy and collagen implant (DSCI) surgery in glaucoma patients.

Methods: 54 eyes of 52 patients with medically uncontrolled open angle glaucoma with advanced field loss underwent DSCI under topical anaesthesia. Follow-up period was 24 months.

Results: The mean preoperative IOP was 24.7 +/- 6.2 mmHg and decreased to 15.1 +/- 4.0 mmHg at 24 months (p = 0.0068). During the follow- up period, 36 of 54 eyes (66%) received no topical antiglaucomatous medications. In 18 eyes, monotherapy with topical beta blockers (Betaxolol HCl) was added to the regimen. At last visit, only two patients (3.8%) had IOP greater than 18 mmHg. We did not detect any additional optic disc changes, visual field or visual acuity defects postoperatively. Detailed slit-lamp examination revealed no anterior segment complications regarding the probable complications of trabeculectomy. None of the patients developed surgery related cataract. As a complication, we diagnosed one case of self-limited, shallow choroidal detachment.

Conclusions: DSCI appears to provide considerable medium term IOP decrease with few postoperative complications without deteriorating visual acuity. Owing to our medium term results, we believe that DSCI could be a valuable alternative to trabeculectomy especially in cases of advanced medically uncontrolled open angle glaucoma.

Authors
H Ates, K Andac, O Uretmen