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Abstract #18296 Published in IGR 3-3
Nonperforating trabecular surgery with reticulated hyaluronic acid implant
Li MChinese Journal of Ophthalmology 2001; 37: 404
OBJECTIVE: To evaluate the clinical results of nonperforating trabecular surgery (NPTS) with reticulated hyaluronic acid implantation. METHODS: Twenty cases (28 eyes) of advanced open-angle glaucoma (C/D = 0.86 ± 0.14) underwent NPTS with reticulated hyaluronic acid implantation. Postoperatively, the intraocular pressure (IOP), intraocular reactions, and bleb appearance were recorded, and gonioscopy and ultrasound biomicroscopy were performed. RESULTS: The mean follow-up was 9.2 ± 3.4 months. Mean IOP was 28.1 ± 10.2 mmHg preoperatively and 17.5 ± 4.1 mmHg postoperatively, the difference being significant (t = 5.776, p < 0.001). The number of drugs used for anti-glaucoma was 2.04 ± 0.74 preoperatively and 0.71 ± 0.71 postoperatively (t = 8.103, p < 0.001). On the last visit, in 27 eyes (96.4%) IOP was ≤21 mmHg, and among these, there were 12 eyes (42.8%) without anti-glaucoma medicine and 15 with. In 13 eyes (46.4%), IOP was decreased 10 mmHg, six of which eyes were not taking any anti-glaucoma medicine and seven of which were. There was no flare and cells in the anterior chamber in 14 eyes. In ten eyes, there was only slight flare that disappeared in two to six days. In four eyes, there was a small amount of hyphema that was absorbed in three to seven days. After operation, there was an obvious diffuse bleb in each eye; at the last visit, there were functional blebs in 19 eyes, and successful filtration was ceased in nine eyes within 1.5-3 months. Intraoperatively, in five eyes, microperforations occurred in the trabecular meshwork without iris prolapse and, after operation, using gonioscopy, the perforation could be observed in three eyes. In another four eyes, there was no intraoperative perforation, but a small fissure could be seen on gonioscopy. In the postoperative one to eight months, ultrasound biomicroscopy was performed, and it was shown that the implant had not degraded. CONCLUSIONS: The elevated IOP in patients with open-angle glaucoma can be effectively reduced by NPTS, and the number of drugs being used for anti-glaucoma treatment decreased. The postoperative complications were much less because of no intraoperative penetration of the anterior chamber. Therefore, NPTS is a very hopeful and practicable new form of anti-glaucoma surgery. LA: Chinese
Dr M. Li, Department of Ophthalmology, The First Hospital, Beijing University, Beijing 100034, China
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
