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Abstract #18294 Published in IGR 3-3
Five-year results of deep sclerectomy with collagen implant
Shaarawy T; Karlen M; Schnyder C; Achache F; Sanchez E; Mermoud AJournal of Cataract and Refractive Surgery 2001; 27: 1770-1778
PURPOSE: To study prospectively the success rate and complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure. METHODS: This nonrandomized prospective trial comprised 105 eyes of 105 patients with medically uncontrolled primary or secondary open-angle glaucoma. Visual acuity, intraocular pressure (IOP), and slit-lamp examinations were performed before and after surgery at one and seven days, and at one, three, six, nine, 12, 18, 24, 30, 36, 48, 54, 60, and 66 months. Visual field examinations were repeated every six months. Qualified success was defined as IOP below 21 mmHg with or without medication. Complete success was defined as IOP lower than 21 mmHg without medication. RESULTS: The mean follow-up was 43.2 ± 14.3 months (SD). Mean IOP was 26.8 ± 7 mmHg preoperatively, 5.1 ± 3 mmHg one day postoperatively, and 11.8 ± 3 mmHg 60 months postoperatively. At 60 months, the qualified success rate was 94.8% and the complete success rate 61.9%. IOP was lower than 21 mmHg with medication in 32.1% of patients at 60 months; 48 patients (45.7%) had an IOP of 15 mmHg or lower without medication. No patient developed a shallow or flat anterior chamber, endophthalmitis, or surgery-induced cataract. However, 23 (21.9%) had progression of a pre-existing senile cataract. Injections of 5-fluorouracil were given to 25 patients (23.8%) who had DSCI to salvage encysted blebs. The mean number of medications per patient was reduced from 2.30 ± 0.76 to 0.49 ± 0.72. CONCLUSION: DSCI provided reasonable IOP over a long-term follow-up with few immediate postoperative complications.
Dr A. Mermoud, Hôpital Ophtalmique Jules Gonin, Avenue de France 15, CH-1004 Lausanne, Switzerland. tschaarawy@yahoo.com
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
