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Abstract #26658 Published in IGR 12-3
New minimally invasive, deep sclerotomy ab interno surgical procedure for glaucoma, six years of follow-up
Pajic B; Pajic-Eggspuehler B; Haefliger IJournal of Glaucoma 2010;
PURPOSE: The goal of this study is to show the efficacy and safety of an innovative surgical procedure regarding the treatment of open-angle and juvenile glaucoma known as sclerothalamotomy ab interno (STT ab interno). PATIENTS AND METHODS: Between February and July 2002 surgery was performed in 58 eyes of 58 consecutive patients, of which 53 were diagnosed with open-angle and 5 with juvenile glaucoma. The procedure was performed with the assistance of a custom-made high-frequency dissection probe (19 gauge with a tip of 0.3null1 mm), which applies a bipolar current of 500 kHz frequency. The probe penetrates approximately 1 mm into the nasal sclera (ab interno) and through the trabecular meshwork and Schlemm's canal, thus forming a deep sclerotomy or "thalami" of 0.3 mm height and 0.6 mm width. RESULTS: The average baseline intraocular pressure (IOP) was 25.6(plus or minus)2.3 mm Hg (range: 18-48 mm Hg) for the open-angle glaucoma group and 39.6(plus or minus)2.3 mm Hg (range: 34-46 mm Hg) for the juvenile glaucoma group. All patients had a minimum follow-up of 72 months. The mean IOP for the stated period was 14.7(plus or minus)1.8 mm Hg for the open-angle glaucoma group and 13.2(plus or minus)1.3 mm Hg for the juvenile group. The IOP after surgery was statistically significantly lower than the baseline IOP at all measured intervals (P<0.001). After 72 months only 11 eyes accounted for a 20.8% continuous antiglaucoma therapy. With regard to the procedure no serious complication was documented. CONCLUSIONS: Sclerothalamotomy ab interno is a minimally invasive, safe, and efficient surgical technique for lowering the IOP in open-angle and juvenile glaucoma.
B. Pajic.
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.2.3 Open angle glaucoma with elevated IOP (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
