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Abstract #19177 Published in IGR 3-1
Does the dissection depth and thickness of the deep scleral flap influence the intraocular pressure after viscocanalostomy? A clinico-pathologic correlation
Dietlein TS; Lüke C; Jacobi PC; Konen W; Krieglstein GKKlinische Monatsblätter für Augenheilkunde 2001; 218: 168-173
BACKGROUND: Non-perforating glaucoma surgery preserves the integrity of the trabecular meshwork in order to avoid postoperative hypotony. The purpose of this study was to investigate whether the morphological variability of the excised deep scleral flap influences postoperative intraocular pressure (IOP) after viscocanalostomy. METHODS: Light microscopy of the deep scleral flap was performed in 17 patients who had undergone viscocanalostomy. Morphological parameters (thickness and dissection level of the deep scleral flap) were correlated with postoperative IOP. RESULTS: The mean thickness of the deep scleral flap was 309 ± 95 μm; the dissection level was too deep in five cases (trabecular tissue excised) and too high in six cases (no sign of Schlemm's canal). The maximum preoperative IOP was 36.2 ± 8.5 mmHg and dropped to 10.6 ± 5.7 mmHg at Day 1 postoperatively and 12.4 ± 4.9 mmHg at Day 3/4 postoperatively. At a median follow-up of six months, IOP was 21.7 ± 5.5 mmHg. A significant correlation between postoperative IOP and the morphology of the deep scleral flap could not be demonstrated. CONCLUSIONS: Variations of the thickness and depth of the deep scleral flap showed little influence on initial IOP level following viscocanalostomy. Other factors, e.g., suturing of the external flap or invisible microruptures of the trabecular meshwork, could be of importance for early postoperative IOP. LA: German
Dr T.S. Dietlain, Universitäts-Augenklinik Köln, Joseph-Stelzmann-Strasse 9, 50931 Cologne-Lindenthal, Germany
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)